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 & Tools
compliance reportingmedical loss ratio auditingcompliance monitoring strategiesregulatory interpretationpolicy developmentcompliance auditsrisk assessmentsproject managementHIPAAregulatory documentation
Soft Skills
communicationanalytical skillsproblem-solvingrelationship managementorganizational skillsleadershipcollaborationattention to detailstrategic thinkingclient management