Remote Health Care Compliance Oversight Specialist

Centene Corporation; Missouri; Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements

Job summary

Centene Corporation seeks a Compliance Oversight professional to participate in the governance of corporate ethics and regulatory compliance for WellCare and delegated subcontractors. You will review, monitor, and assess compliance with contracts and government program requirements, driving remediation with business owners and partners.

Responsibilities include evaluating risk, producing detailed reports, and supporting corrective action plans across local markets and corporate Shared Services.

Qualifications

• 3+ years of experience in Managed Care/Health Insurance.
• Preferred 1+ year in project oversight roles with ability to drive implementation.
• Preferred 1+ year reading, analyzing, and interpreting State and Federal laws, rules and regulations.
• Preferred 1+ year State Medicaid or Federal managed care compliance.

Responsibilities

• Oversee compliance program activities and monitoring for WellCare and delegated subcontractors.
• Collaborate with business owners and vendors to drive remediation and ensure contract/regulatory requirements are met.
• Assess new/ amended Government-sponsored health care program contracts and requirements.
• Evaluate effectiveness of compliance programs and procedures,
• Prepare formal written reports with evidence and recommendations.
• Coordinate with other departments to route compliance issues for resolution.

Skills

Managed Care/Health Insurance

Project Oversight

Legal/Regulatory interpretation

Medicaid/Managed Care compliance

Education

Bachelor's degree in related field

Associates degree with 4 years experience

HS/GED with 5 years experience

Job description

Centene Corporation seeks a Compliance Oversight professional to participate in the governance of corporate ethics and regulatory compliance for WellCare and delegated subcontractors. You will review, monitor, and assess compliance with contracts and government program requirements, driving remediation with business owners and partners.

Responsibilities include evaluating risk, producing detailed reports, and supporting corrective action plans across local markets and corporate Shared Services.