Remote Senior Compliance & Audit Specialist

Centene Corporation; Missouri; À distance; USD 70 000 - 126 000; Plein temps

Avantages offerts par ce poste

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible remote/hybrid/field or office

Résumé du poste

Centene Corporation seeks a seasoned professional to audit, monitor, and oversee its ethics and compliance program across Centene, its brokers, distribution partners, and third parties. You will drive remediation, educate on program requirements, and develop corrective action plans to maintain integrity and comply with government-sponsored health care program requirements.

The role involves producing formal reports, directing issues for research and resolution, and supporting the ongoing

Qualifications

• Bachelor's Degree in Healthcare, Audit, Business, or related field or equivalent experience required.
• CHC - Certified Healthcare Compliance preferred
• Certified Internal Auditor (CIA) preferred
• High School/GED and 5+ years of related experience required

Responsabilités

• Prepare formal written reports on audit, oversight and monitoring activity findings and recommendations.
• Collaborate to direct compliance issues to appropriate channels for research and resolution.
• Serve as a key contributor to Issue Management by reviewing and evaluating the status and effectiveness of corrective action plans, tracking identified issues through remediation and closure, and providing comprehensive follow up.
• Communicate the importance of compliance and the Compliance Program, including promoting increased awareness of the Enterprise Ethics and Compliance Program; understanding of new and existing compliance issues and related policies and procedures; and importance of implementing and maintaining effective oversight and monitoring activities.
• Support management in the development and maintenance of monitoring and auditing tools designed to evaluate internal, brokers and distribution partners and/or third party/subcontractor compliance with aspects of government-sponsored health care program requirements.
• Educate, encourage, and assist those within the company and with the company’s third parties/subcontractors to maintain integrity through oversight and monitoring and in meeting the requirements of Government-sponsored health care programs.
• Assist in the assessment of new and amended government-sponsored health care program contracts and requirements.
• Assist Health Plans, Subsidiaries, Shared Services, and Third Parties/Subcontractors in the identification and assessment of compliance risks.
• Serve as a compliance advisor to business units and third parties with specialized focus, including but not limited to, claims / payments, credentialing, network management, financial solvency.
• Performs other duties as assigned.
• Complies with all policies and standards.

Formation

Bachelor's Degree in Healthcare, Audit, Business, or related field or equivalent experience required

High School/GED and 5+ years of related experience required

Description du poste

Centene Corporation seeks a seasoned professional to audit, monitor, and oversee its ethics and compliance program across Centene, its brokers, distribution partners, and third parties. You will drive remediation, educate on program requirements, and develop corrective action plans to maintain integrity and comply with government-sponsored health care program requirements.

The role involves producing formal reports, directing issues for research and resolution, and supporting the ongoing