Remote Compliance Manager - Healthcare Contracts

Centene Corporation; Indiana (PA); Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off

Job summary

Centene Corporation is seeking a compliance leader to manage the compliance department functions, including monitoring, auditing, and reporting to ensure adherence to regulatory, contractual, and legal requirements. The role requires 4–6 years of compliance experience and a bachelor’s degree in health care administration or related field.

The position allows remote work from home with Indiana residency required per contract.

Qualifications

• Bachelor’s degree in health care administration, compliance or related field or equivalent experience.
• 4-6 years of compliance experience including risk assessment against contract and regulatory requirements, creation and execution of auditing, monitoring and reporting processes, administration of correction action plans, implementation of written policies and procedures, developing and delivering compliance training and education.
• Managed health and/or behavioral health experience preferred.

Responsibilities

• Manage approval and submission of timely and accurate contract and regulatory required report deliverables.
• Oversee all contracts updates including creating new and updating existing contracts with Health Plans, States and consultants/vendors.
• Conduct periodic assessments to ensure compliance against contract requirements.
• Oversee creation and implementation of corrective action plans to reduce or eliminate risk resulting from non-compliance with contract requirements or performance deficiencies.
• Collaborate with Health Plans and States to maintain/improve customer satisfaction specific to delegated functions and compliance with contract requirement.
• Manage submission of consumer and provider communication materials, including review and timely submission to Health Plans and States.
• Manage responses to state regulatory agency complaints and inquiries.
• Determine licensure requirements and administration of ongoing licensure maintenance, including research in new markets and timely filing for recurring deliverables.
• Support responses to requests for proposals (RFPs) and new business implementations by completing assigned compliance tasks timely and accurately.
• Participate in new business implementations, including identification and tracking of required contract report deliverables and new reporting/materials.
• Design, implement and improve processes to prevent, detect and respond to compliance issues and concerns.
• Create and deliver compliance training for all employees on an annual basis and as needed basis.

Skills

Auditing

Monitoring

Risk assessment

Policy development

Training delivery

Education

Bachelor’s degree in health care administration, compliance or related field

Job description

Centene Corporation is seeking a compliance leader to manage the compliance department functions, including monitoring, auditing, and reporting to ensure adherence to regulatory, contractual, and legal requirements. The role requires 4–6 years of compliance experience and a bachelor’s degree in health care administration or related field.

The position allows remote work from home with Indiana residency required per contract.