Remote Senior Compliance & Vendor Oversight Lead

Centene Corporation; Missouri; Ibrido; USD 70.000 - 126.000; Tempo pieno

Descrizione del lavoro

Centene Corporation seeks a governance and compliance leader to oversee ethics and regulatory compliance programs for the company and its vendors. You will monitor government-sponsored health care program requirements, manage the contract lifecycle, and drive improvements across teams.

The role requires experience in managed care, strong analysis of state and federal laws, and ability to communicate regulatory updates.

Competenze

• Bachelor's Degree in related field; or, equivalent experience. (required)
• Master's Degree preferred
• Juris Doctor (JD) preferred
• 4+ years Managed Care/Health Insurance and knowledge of relevant legal and regulatory frameworks required
• 2+ years Project oversight with demonstrated ability to drive implementation and influence others preferred
• 2+ years Reading, analyzing, and interpreting State and Federal laws, rules and regulations preferred
• 2+ years State Medicaid or government sponsored healthcare compliance preferred

Mansioni

• Collaborates with internal teams and external vendors or subcontractors to promote contract compliance and uphold program integrity through structured oversight and monitoring of government-sponsored healthcare programs.
• Oversee the management of the entire contract lifecycle, from drafting to finalization, ensuring compliance and mitigating risks.
• Conducts reviews, audits, and assessments of vendor relationships to ensure adherence to Centene's and Government-sponsored health care program Requirements.
• Collaborates with business owners and vendors to drive process improvements, maintaining integrity, and ensuring compliance with Government-sponsored healthcare program requirements.
• Leads the timely, consistent, and accurate communication of state and federal regulatory updates impacting Medicaid and Marketplace regulatory filings in collaboration with market and product compliance officers.
• Prepares, organizes, and package subcontractor files for approval/notification.
• Develop clear, accurate and timely written reports detailing oversight and monitoring findings and recommendations.
• Ensures all supporting documentation and workpapers meet Centene and department standards, including the inclusion of sufficient evidence to substantiate findings.
• Partners with internal departments and subcontractors to route compliance concerns to the appropriate channels for investigation and resolution.
• Supports regulatory notifications and documentation of approvals/notifications.
• Performs other duties as assigned.
• Complies with all policies and standards.

Formazione

Bachelor's Degree in related field

Master's Degree

Juris Doctor (JD)

Descrizione del lavoro

Centene Corporation seeks a governance and compliance leader to oversee ethics and regulatory compliance programs for the company and its vendors. You will monitor government-sponsored health care program requirements, manage the contract lifecycle, and drive improvements across teams.

The role requires experience in managed care, strong analysis of state and federal laws, and ability to communicate regulatory updates.