Centene
Health Plan
ComplianceOfficer
Neural analysis suggests this role is
optimal for Senior candidates.
“Compliance Officer at Centene. Skills: Health plan compliance program leadership, State Medicaid program compliance, CMS Medicare compliance, Regulatory strategy and implementation, Risk assessment and mitigation. Provide strategic leadership and oversight for the health plan compliance program. Ensure accurate and timely execution and regulatory deliverables across business and operational areas”
What You'll Achieve.
Ensure accurate and timely execution and regulatory deliverables; Ensure timely submission of all applicable regulatory filings and deliverables; Hold business owners accountable for timely remediation and sustained compliance; Provide regular reporting to market and enterprise leadership regarding risks, trends and remediation activities
Industry & Context.
Identify, evaluate and analyze the impact of state regulatory changes
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
Nice to Have
Master's Degree in related field preferred, 10+ years Compliance/Enterprise Risk Management preferred
What You'll Do.
Provide strategic leadership and oversight for the health plan compliance program
Ensure accurate and timely execution and regulatory deliverables across business and operational areas
and ongoing effectiveness of the market compliance program
Oversee compliance with CMS Medicare requirements
Serve as senior compliance leader and single point of contact for state interactions
Serve as senior leadership in regulatory audit activities
Collaborate to identify
and reduce compliance and business risks
Direct corrective action planning and hold business owners accountable for remediation
Provide oversight of delegated entities
and material subcontractors
Chair or support market compliance committees
and develop compliance team members
Maintain and track contract documentation
Medicaid contract amendments
and various regulatory measures
and processes comply with state regulatory standards
Provide guidance on regulatory and contract language
Develop strategic relationships with state agencies and policymakers
evaluate and analyze the impact of state regulatory changes
Represent senior management at state committees and industry forums
Maintain deep knowledge of New Jersey Medicaid and applicable state regulatory requirements
How You'll Work.
Team & Collaboration
Collaborate with Corporate Enterprise Risk Management and market leaders; Work with Operational Departments; Provide guidance to various departments; Develop strategic relationships with agencies; Represent senior management at various state committees, meetings, and industry forums
Communication Scope
Provide regular reporting to market and enterprise leadership
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 job have the flexibility to work remote from home anywhere in the Continental United States, however it is highly preferred that the selected candidate resides in New Jersey.** **Position Purpose:** Provide strategic leadership and oversight for the health plan compliance program, including compliance governance, regulatory strategy, policy development, and cross-functional implementation. Ensure accurate and timely execution and regulatory deliverables across business and operational areas. * Lead the design, execution, and ongoing effectiveness of the market compliance program in alignment with enterprise standards and regulatory expectations. * Oversee compliance with CMS Medicare requirements including SNP related obligations, and ensure timely submission of all applicable regulatory filings and deliverables. * Serve as senior compliance leader and single point of contact for state interactions, compliance meetings and market level escalations. * Serve as senior leadership in all Department of Insurance, Medicaid agency, and other regulatory audit activities applicable to New Jersey market. * Collaborate with Corporate Enterprise Risk Management and market leaders to identify, assess, document, and reduce compliance and business risks. * Internal compliance auditing and monitoring activities, direct corrective action planning, and hold business owners accountable for timely remediation and sustained compliance. * Provide oversight of delegated entities, vendors, and material subcontractors, including annual oversight performance monitoring and corrective action follow up. * Chair or support market compliance committees and provide regular reporting to marke
Applying for this Compliance Officer role?
Most applicants get filtered before a human reads their resume. See if yours makes the cut.
How to Apply on Workday
- Workday has a multi-step form — save your progress after every section.
- "Apply With LinkedIn" can fail or lose data; manual entry is more reliable.
- Watch for the "Submit for Review" final step — hitting "Save" alone does not submit.
- Job requisition numbers are useful when following up with HR by email.
ANONYMOUS · UNFILTERED
What do employees actually say about Centene?
Real rants from real employees. Read before you apply.