Senior Compliance Risk Adjustment Analyst
Centene Corporation
Medicaid Regulatory Analyst
Health Care Service Corporation
full-time
Posted on:
Location: Illinois • 🇺🇸 United States
Visit company websiteSalary
💰 $40,900 - $91,000 per year
Job Level
JuniorMid-Level
About the role
- This position is responsible for monitoring Medicaid and related regulations and policy changes impacting operations; participating in audits; supporting tracking and submission of Medicaid state contract(s) related deliverables, including fulfillment of internal and contractual reporting requirements; working with other areas of the organization on the development, testing and implementation of organization, process and system changes to ensure the requirements of the Medicaid program are met; and assisting MCO in coordination of the contract with the state/CMS enterprise-wide.
- This position will rely heavily on policy writing and SOP documentation creation, review, and/or auditing.
Requirements
- Bachelor Degree in Business OR 2 years’ experience with health insurance.
- 1 year of experience with health insurance benefits and/or operations.
- Knowledge of Medicaid and Medicare product(s).
- Verbal and written communication skills.
- Experience presenting trends and findings.
- 1+ year experience writing/auditing SOPs for a MCO (Managed Care Organization)
- 1+ year experience reading/comprehending healthcare policy documentation
- 1+ year experience writing contracts
- Knowledge of Medicare product(s) not needed.
