Centene
Health
ComplianceOfficer
Neural analysis suggests this role is
optimal for Senior candidates.
“Compliance Officer at Centene. Skills: Compliance, Risk Management. Oversee all compliance functions for the Mississippi health plan including communication and coordination of policy development. Oversee the accurate and timely submission of over-contract deliverables for all lines of business and service delivery areas”
Industry & Context.
Applicants for this role must reside in the state of Mississippi and go into the office at least once a week
What They're Looking For.
Must Have
Bachelor's Degree in related field, or equivalent experience required, 7+ years Compliance program management and contract experience with State Medicaid programs including internal and State audits required, 5+ years Health care regulatory agencies in development of compliance and fraud required, 5+ years Overseeing implementation of contract requirements required, Applicants for this role must reside in the state of Mississippi and go into the office at least once a week
Nice to Have
Master's Degree in related field preferred, 10+ years Compliance/Enterprise Risk Management preferred
What You'll Do.
Oversee all compliance functions for the Mississippi health plan including communication and coordination of policy development
Oversee the accurate and timely submission of over-contract deliverables for all lines of business and service delivery areas
Oversee the accurate and timely submission of all CMS Medicare SNP requirements
Serve as senior leadership and single point of contact in all State compliance meetings and interactions
Manage direct correspondence and daily interaction with all state regulators
Serve as senior leadership in all Department of Insurance and HHSC audit processes
Managing all facets of the audit and communications
Serve as senior leadership in Enterprise Risk Management process working directly with corporate ERM and Executive Management team to ensure current evaluation and documentation of business risks
Conduct internal compliance audits
write corrective action plans and work with contract and department managers to ensure timely completion and compliance with federal
state and local regulatory requirements
Accountable for the management and oversight of compliance for all health plan material subcontractors to include directing the performance of annual oversight
Performs other duties as assigned
Comply with all policies and standards
How You'll Work.
Team & Collaboration
working directly with corporate ERM and Executive Management team; work with contract and department managers
Communication Scope
communication and coordination of policy development; direct correspondence and daily interaction with all state regulators; Managing all facets of the audit and communications
Full Job Description
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. **Applicants for this role must reside in the state of Mississippi and go into the office at least once a week.** **Position Purpose:** * Oversee all compliance functions for the Mississippi health plan including communication and coordination of policy development. Oversee the accurate and timely submission of over-contract deliverables for all lines of business and service delivery areas. * Oversee the accurate and timely submission of all CMS Medicare SNP requirements. * Serve as senior leadership and single point of contact in all State compliance meetings and interactions. * Manage direct correspondence and daily interaction with all state regulators. * Serve as senior leadership in all Department of Insurance and HHSC audit processes. * Managing all facets of the audit and communications. * Serve as senior leadership in Enterprise Risk Management process working directly with corporate ERM and Executive Management team to ensure current evaluation and documentation of business risks. * Conduct internal compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with federal, state and local regulatory requirements. * Accountable for the management and oversight of compliance for all health plan material subcontractors to include directing the performance of annual oversight. * Performs other duties as assigned. * Comply with all policies and standards. Education/Experience: * Bachelor's Degree in related field, or equivalent experience required. Master's Degree in related field preferred. * 7+ years Compliance program management and contract experience with State Medicaid programs including internal
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