Centene
healthcare
Manager,CompliancePolicyOversight
Neural analysis suggests this role is
optimal for Mid candidates.
“Manager, Compliance Policy Oversight at Centene. Skills: compliance policy oversight, regulatory requirements, policy management, risk assessment, compliance monitoring. Manage and implement strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company. Manage an end-to-end policy life cycle and governance processes”
What You'll Achieve.
ensure successful maintenance and implementation of compliance programs that meet regulatory requirements; support consistent, high quality policy writing across the organization; mitigate any potential violations; develop, implement and maintain production and quality standards for the compliance program; ensure compliance with the company’s strategic plan; establish the department’s strategic vision, objectives and attendant policies and procedures for the organization
Industry & Context.
Investigate issues and mitigate any potential violations including: gathering information and recommending a course of action, preparing reports by researching, analyzing and summarizing information
What They're Looking For.
Must Have
Bachelors’ degree in related field or equivalent experience, 4+ years of compliance experience, at least 2+ years of Medicaid, Medicare or Commercial Managed Care experience
Nice to Have
Master's or Juris Doctorate degree, compliance experience, preferably in a healthcare environment, Previous experience demonstrating effective interaction with federal and state regulatory agencies in a managed care or insurance environment
What You'll Do.
Manage and implement strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company
Manage an end-to-end policy life cycle and governance processes
Maintain clear policy standards
and guidance to support consistent
high quality policy writing across the organization
Support responses to audits
and internal reviews related to company policies and procedures
Investigate issues and mitigate any potential violations including: gathering information and recommending a course of action
preparing reports by researching
analyzing and summarizing information
implement and maintain production and quality standards for the compliance program
Perform periodic audits
risk assessments and conduct related ongoing compliance monitoring activities
Evaluate and implement changes to service functions and performance in relation to company mission
philosophy objectives and policies
direct and coordinate the implementation of policy decisions and ensure compliance with the company’s strategic plan
establish the department’s strategic vision
objectives and attendant policies and procedures for the organization
Research and incorporate best practices into operations and ensure that department functions are coordinated with other operating departments
How You'll Work.
Team & Collaboration
ensure that department functions are coordinated with other operating departments
Process & Methodology
Manage an end-to-end policy life cycle and governance processes, implementation of policy decisions
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. **Position Purpose:** Manage and implement strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company * Manage an end-to-end policy life cycle and governance processes * Maintain clear policy standards, templates, and guidance to support consistent, high quality policy writing across the organization * Support responses to audits, regulatory inquiries, and internal reviews related to company policies and procedures * Investigate issues and mitigate any potential violations including: gathering information and recommending a course of action, preparing reports by researching, analyzing and summarizing information * Develop, implement and maintain production and quality standards for the compliance program. * Perform periodic audits, risk assessments and conduct related ongoing compliance monitoring activities. * Evaluate and implement changes to service functions and performance in relation to company mission, philosophy objectives and policies. * Plan, direct and coordinate the implementation of policy decisions and ensure compliance with the company’s strategic plan, establish the department’s strategic vision, objectives and attendant policies and procedures for the organization. * Research and incorporate best practices into operations and ensure that department functions are coordinated with other operating departments. **Education/Experience:** * Bachelors’ degree in related field or equivalent experience. * Master's or Juris Doctorate degree preferred. * 4+ y
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