Senior Compliance Analyst, Duals (D-SNP) Products

Centene; United States; Remote; USD 68,000 - 124,000; Full time

Job summary

Join a forward-thinking organization that is dedicated to transforming healthcare for millions. This role offers the opportunity to partner with leadership in ensuring compliance with critical regulatory requirements. You will be responsible for managing compliance projects, conducting audits, and developing training programs. With a strong emphasis on workplace flexibility, you can work remotely from anywhere in the Continental United States. This position not only promises a competitive salary but also a comprehensive benefits package that supports your career growth and work-life balance.

Benefits

Health Insurance

401K Plan

Tuition Reimbursement

Paid Time Off

Flexible Work Arrangements

Qualifications

• 4+ years of experience in Compliance and regulatory affairs.
• Strong knowledge of Medicare and D-SNP regulations.

Responsibilities

• Manage compliance reporting and respond to regulatory inquiries.
• Develop and deliver compliance training programs.

Skills

Regulatory Compliance

Project Management

Policy Development

Risk Assessment

Education

Bachelor's Degree in Law

Equivalent Experience

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States.

Position Purpose:

Partner with leadership to ensure Centene Corporation's compliance with the Duals (D-SNP) Program requirements. Responsibilities include providing regulatory interpretation, compliance reporting, leading special projects, and developing and implementing compliance auditing and monitoring strategies for D-SNPs.

• Respond to external requests for information related to Duals and SMAC regulatory filings.
• Manage compliance reporting responsibilities for Duals (and Medicare with D-SNP-specific or separate) and respond to inquiries from state and federal regulatory agencies.
• Lead Duals compliance projects or implementations.
• Review and synthesize Duals regulatory requirements; create policy or position statements.
• Partner with leadership to manage the annual SMAC assessment and track caps.
• Communicate Duals (state and federal) requirements to internal and external clients.
• Develop guidance and lead the identification, implementation, and maintenance of Duals and overlapping Medicare compliance policies, procedures, and work instructions.
• Identify, analyze, and resolve Duals compliance issues.
• Maintain and review D-SNP regulatory documentation to ensure compliance with standards.
• Develop and deliver Duals compliance training programs.
• Conduct periodic compliance audits, risk assessments, and related activities.
• Collaborate with the Duals Manager and health plans to manage relationships with regulatory agencies and clarify requirements and implementations as needed.
• Support interim responsibilities of the Duals Compliance Manager, including assisting the health plan compliance officer with D-SNP-specific tasks. Act as a company-wide resource and liaison on policies, contracts, communications, workflows, and quality initiatives.
• Perform other duties as assigned and ensure compliance with all policies and standards.

Education/Experience:

• Bachelor's Degree in Law or a related field; or equivalent experience.
• At least 4 years of experience in Compliance and/or regulatory affairs.
• Experience in project management with knowledge of laws and regulations related to compliance, especially Medicare, D-SNP, and state regulations.

Pay Range: $68,700.00 - $123,700.00 per year

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and flexible work arrangements (remote, hybrid, field, or office). Actual pay will be adjusted based on skills, experience, education, and other factors. Total compensation may include additional incentives.

Centene is an equal opportunity employer committed to diversity. We consider all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics. Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws.