Remote Compliance Oversight Lead

Centene Corporation; Missouri; Hybrid; USD 90,000 - 130,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Remote work flexibility

Job summary

Centene Corporation is seeking an experienced compliance leader to oversee and drive complex compliance projects from planning through reporting. The role mentors staff, collaborates with multiple departments, and ensures corrective action plans are completed effectively.

You will educate teams on compliance programs, coordinate with internal and external auditors, and contribute to annual risk assessments while aligning with State Medicaid, OIG and CMS requirements.

Qualifications

• A Bachelor's Degree in a related field; an additional 2 years of Compliance/Auditing experience may be substituted in lieu of the degree.
• 5+ years of experience in Compliance/Auditing required.
• 3+ years of experience in State or Federal Managed Care Programs required.
• 1+ year of experience in reading, analyzing, and interpreting State and Federal laws, rules and regulations required.

Responsibilities

• Provides work guidance, direction and mentoring to department associates.
• Collaborates with other departments to direct compliance issues to appropriate channels for research and resolution.
• Consults with management, in-house counsel, and/or the VP of Corporate Compliance as needed to resolve difficult compliance issues.
• Communicates the importance of compliance and the compliance program to health plan staff, including promoting awareness of the Corporate Ethics and Compliance Program, understanding of policies and procedures, and the importance of internal compliance audits.
• Works closely with Corporate Compliance management regarding the status of projects and assigned deliverables.
• Provides independent appraisals, analyses, and observations for examining and evaluating the adequacy and effectiveness of business processes, internal controls, and regulatory compliance.
• Ensures all monitoring and oversight testing, documentation, and reporting is completed with quality, in a timely manner, and in accordance with professional standards.
• Ensures internal and external corrective action plans are tracked to completion.
• Educates and assists the company to maintain integrity through oversight and monitoring and in meeting State Medicaid Programs, OIG and CMS requirements.
• Communicates and coordinates with external auditors.
• Assists Corporate Audit & Oversight management in preparing the annual compliance risk profile and in developing/executing monitoring and oversight work plans.
• Assists Corporate Audit & Oversight management in preparing monthly, quarterly, and annual reporting to Sr. Management and the Board of Directors.
• Performs other projects as assigned.

Education

Bachelor's Degree in a related field

Certified in HealthCare Compliance (CHC)

Certified Compliance Ethics Professional (CCEP)

Certified Internal Auditor (CIA)

Certified Fraud Examiner (CFE)

Job description

Centene Corporation is seeking an experienced compliance leader to oversee and drive complex compliance projects from planning through reporting. The role mentors staff, collaborates with multiple departments, and ensures corrective action plans are completed effectively.

You will educate teams on compliance programs, coordinate with internal and external auditors, and contribute to annual risk assessments while aligning with State Medicaid, OIG and CMS requirements.