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
compliance managementMedical Loss Ratio (MLR)auditingmonitoringrisk assessmentcorrective action planspolicy implementationcompliance trainingreporting processesManaged Care
Soft skills
collaborationcommunicationleadershiporganizational skillsproblem-solvingtrainingstaff managementprocess improvementanalytical skillsattention to detail