Remote Health Compliance Oversight Specialist

Centene Corporation; United States; Remote; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Holidays

Flexible work arrangements

Job summary

Centene Corporation is seeking a compliance oversight professional to participate in the governance of ethics and regulatory compliance across WellCare and delegated subcontractors. Responsibilities include oversight, audits, and remediation coordination to meet government-sponsored health care program requirements.

The role emphasizes collaboration with business owners and vendors, assessment of contracts, and evaluation of program effectiveness.

Qualifications

• Bachelor’s Degree in Related field or Associates with 4 years of applicable experience or HS/GED with 5 years of applicable experience in lieu of a Bachelor’s degree
• Required 3+ years of experience in Managed Care/Health Insurance
• Preferred 1+ year of experience in project oversight to drive implementation and influence others
• Preferred 1+ year of experience in reading, analyzing, and interpreting State and Federal laws, rules and regulations
• Preferred 1+ year of experience in State Medicaid or Federal managed care compliance

Responsibilities

• Oversee compliance programs for WellCare/contracted subcontractors
• Assist in evaluating new/ amended Government-sponsored health care program contracts
• Identify and assess compliance risks across markets and shared services
• Evaluate effectiveness of compliance programs and policies
• Prepare formal written reports with findings and recommendations
• Collaborate with departments to address compliance issues
• Follow up on corrective actions with stakeholders and committees
• Participate in special projects and training
• Perform other duties and comply with all policies

Skills

Compliance oversight

Project management

Stakeholder communication

Regulatory interpretation

Education

Bachelor’s Degree in related field

Associates degree with 4 years experience

HS Diploma/GED with 5 years experience

Job description

Centene Corporation is seeking a compliance oversight professional to participate in the governance of ethics and regulatory compliance across WellCare and delegated subcontractors. Responsibilities include oversight, audits, and remediation coordination to meet government-sponsored health care program requirements.

The role emphasizes collaboration with business owners and vendors, assessment of contracts, and evaluation of program effectiveness.