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Senior Compliance Auditor - Hybrid

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  • Business Area: Legal & Compliance
  • Job Type: Full time
  • Date Posted:
  • Job Number: 1491255
This job is available in 4 locations

Senior Compliance Auditor - Hybrid

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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.

**This is a Florida based hybrid position with 2-3 days a month in office**

Position Purpose: With our Sunshine Health Compliance team, you will be responsible for the development and implementation of the health plan’s compliance audit work plan. Completes Prospective and retrospective audits on a monthly, quarterly and annual basis.

  • Identify regulatory oversight deficiencies, process gaps and communicate audit observations, analyzes findings to provide recommendations on process improvements to the Chief Compliance Officer.
  • Utilize compliance knowledge to analyze audit findings and in answering disputed findings.
  • Develop and implement compliance improvement and corrective action plans based on risk analysis, audit findings, and health plan performance.
  • Develop audit processes based on contract requirements defined by Centers for Medicare and Medicaid Services (CMS), State, Federal, Medicaid and/or NCQA guidelines.
  • Maintain documentation on health plan performance and provide reports to departments as required for audits and risk assessments.
  • Train internal audit participants/business owners on audit processes.

Education/Experience: Bachelor’s degree in Health Care, Law, Accounting, Psychology or related field. Master’s degree preferred. 3+ years of healthcare compliance and auditing/monitoring experience.

License/Certification: Compliance or auditing certifications preferred

Preferred Skills:

Strong attention to detail

Excellent writing, verbal and analytical skills

Ability to work independently and multi-task

Pay Range: $67,400.00 - $121,300.00 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. Total compensation may also include additional forms of incentives.

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.

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