Senior Compliance Analyst, Medical Loss Ratio
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Montana • United States
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Salary
💰 $70,100 - $126,200 per year
Job Level
About the role
- Assist in maintaining Centene Corporation’s Medical Loss Ratio Compliance Program
- Provide regulatory interpretation, perform compliance reporting, lead special projects, and develop and implement compliance medical loss ratio auditing and monitoring strategies
- Respond to external requests for information required by the organization for its medical loss ratio regulatory filings
- Manage compliance oversight or medical loss ratio reporting and assist in respond to inquiries from state and federal regulatory agencies
- Manage ethics and compliance medical loss ratio projects or implementations
- Review and synthesize regulatory requirements and create policy and/or position statements
- Communicate state and federal requirements to internal and external clients
- Provide development guidance and assist in the identification, implementation, and maintenance of compliance policies, procedures and work instructions
- Assist in the identification, analysis, and resolution of medical loss ratio compliance issues
- Maintain and review medical loss ratio regulatory documentation necessary to maintain corporate standards
- Perform periodic compliance audits, risk assessments and conducts related to ongoing compliance monitoring activities
- Assist health plans in managing relationships with regulatory agencies and seek to resolve policy issues which may negatively impact service to members
- Serve as a company-wide resource and liaison on medical loss ratio policies, contract issues and provisions, communications, workflow, and quality improvements initiatives
Requirements
- Bachelor’s degree in related legal field or equivalent experience
- Master’s or Juris Doctorate degree preferred and maybe considered in lieu of experience
- 3+ years of related experience in compliance privacy and/or regulatory affairs
- Experience in project management with working knowledge of laws and/or regulations in area of compliance, in particular HIPAA, and state regulations
Benefits
- competitive pay
- health insurance
- 401K
- 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 reportingmedical loss ratio auditingcompliance monitoring strategiesregulatory interpretationpolicy developmentcompliance auditsrisk assessmentsproject managementHIPAAregulatory documentation
Soft skills
communicationanalytical skillsproblem-solvingrelationship managementorganizational skillsleadershipcollaborationattention to detailstrategic thinkingclient management