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 Delaware.
Position Purpose: Oversee all compliance functions for the Delaware health plan including communication and coordination of policy development. Oversee the accurate and timely submission of over-contact 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. Master's degree preferred.
• 7+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits.
• 5-7 years of experience with health care regulatory agencies in development of compliance and fraud programs.
• 5+ years' experience with overseeing implementation of contract requirements.

Pay Range: $145,100.00 - $268,800.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Skills Required