Compliance Oversight Specialist – Non-Clinical
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Florida • Montana • United States
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Salary
💰 $56,200 - $101,000 per year
About the role
- Participates in the oversight of WellCare's and/or its delegated subcontractor's corporate ethics and compliance program
- ongoing oversight and analysis of regulatory compliance issues
- conducting focused reviews and audit
- oversight, and monitoring of activities to assess compliance with WellCare's contractual and regulatory requirements
- collaborates with business owners and/or delegated vendors to drive remediation and assist WellCare and delegated subcontractors to maintain integrity through oversight and monitoring and in meeting Government-sponsored health care program requirements
- assists in the assessment of new and amended Government-sponsored health care program contracts and requirements
- prepares accurate and timely formal written reports on oversight and monitoring activity findings and recommendations and ensure workpapers are properly prepared
Requirements
- A Bachelor's Degree in Related field required, or Associates with 4 years of applicable experience, or HSD/GED with 5 years of applicable experience in lieu of Bachelor’s degree
- 3+ years of experience in Managed Care/Health Insurance
- Preferred 1+ year of experience in project oversight type role with demonstrated ability to drive implementation and influence others
- Preferred 1+ year of experience in reading, analyzing, and interpreting State and Federal laws, rules and regulations
- Preferred 1+ year of experience in State Medicaid or Federal managed care compliance
- A license in one of the following is required: Preferred Other Certified in HealthCare Compliance (CHC)
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
regulatory complianceauditcompliance assessmentreport writingdata analysiscontract analysisremediationoversightmonitoring
Soft Skills
collaborationinfluencecommunicationorganizational skillsattention to detail
Certifications
Certified in HealthCare Compliance (CHC)