Senior Manager, Compliance – Medical Loss Ratio
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Montana • United States
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Salary
💰 $87,700 - $157,800 per year
Job Level
About the role
- Manage the compliance department functions including periodic monitoring and auditing activities
- Provide compliance oversight and execution of key Medical Loss Ratio (MLR) compliance activities
- Develop and maintain the MLR compliance oversight program
- Identify opportunities to improve business practices and processes
- Provide oversight of submission of timely and accurate contract and regulatory Medical Loss Ratio required report deliverables
- Conduct periodic Medical Loss Ratio assessments
- Assist in the creation and implementation of corrective action plans
- Collaborate with Health Plans and States for compliance
- Manage consumer and provider communication materials
- Support responses to RFPs and new business implementations
- Design, implement and improve processes to prevent, detect and respond to Medical Loss Ratio compliance issues
- Create and deliver Medical Loss Ratio compliance training
Requirements
- Bachelor’s degree in health care administration, compliance or related field or equivalent experience
- 5-7 years of compliance experience including risk assessment against contract and regulatory requirements
- creation and execution of auditing, monitoring and reporting processes
- administration of correction action plans
- implementation of written policies and procedures
- developing and delivering compliance training and education
- 2+ years of Managed Care experience
- Management experience including responsibilities for hiring, training, assigning work and managing staff performance.
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
compliance managementMedical Loss Ratio (MLR)auditingmonitoringrisk assessmentcorrective action planspolicy implementationcompliance trainingreporting processesManaged Care
Soft Skills
collaborationcommunicationleadershiporganizational skillsproblem-solvingtrainingstaff managementprocess improvementanalytical skillsattention to detail