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Manager, Compliance & Reporting

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  • Business Area: Legal & Compliance
  • Job Type: Full time
  • Date Posted:
  • Job Number: 1497112
This job is available in 3 locations

Manager, Compliance & Reporting

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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.

Applicants for this job have the flexibility to work remote from home, but must reside in North Carolina.

Position Purpose: Design and implement programs, policies, and practices to ensure State and Federal program contract compliance, as well as compliance with federal and state legal and regulatory requirements.

  • Manage the compliance/reporting staff.
  • Oversee the day-to-day health plan policies and procedures to ensure federal and state regulatory compliance.
  • Validate state and federal deliverable reports for accuracy and ensure timeliness of submission.
  • Review and analysis of health plan deliverables and data to identify trends in performance and opportunities for improvement.
  • Ensure timely, accurate and appropriate submission of all State filings related to health plan licensure.
  • Act as a resource to staff in all health plan departments related to contract and reporting requirements and regulatory compliance.
  • Act as a liaison with State and/or federal agency staff in response to inquiries and requests for information. Interact with Corporate compliance staff, and serve as primary health plan liaison with the Corporate Special Investigations Unit related to fraud and abuse.
  • Conduct oversight audits of health plan procedures and processes to ensure compliance with contractual and regulatory requirements.
  • Coordinate with Marketing Manager and Delegation Oversight Manager for applicable activities and initiatives.
  • Conduct/manage training programs for all health plan staff as required by contract and applicable regulatory requirements.
Education/Experience: Bachelor's’ degree in related field. 4+ years of compliance/regulatory experience in a health care and/or managed care setting/organization. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.Pay Range: $84,300.00 - $151,700.00 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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