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Population Health Clinical Operations Compliance Officer

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  • Business Area: Legal & Compliance
  • Job Type: Full time
  • Date Posted:
  • Job Number: 1498745
This job is available in 1 locations

Population Health Clinical Operations Compliance Officer

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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.

Position Purpose: Direct daily aspects of the state contract compliance functions. Conduct investigations, assist with the development of policies and procedures and communicating the Corporate Compliance Program to employees and other groups. Assist with development and communication of a confidential system to seek guidance on business conduct issues, report suspected violations of law or health plan policies/procedures.
  • Direct activities for system-wide audits established to investigate and monitor compliance with state contract requirements, standards and procedures implemented by the compliance program, reviewing completely all legal duties imposed by government agencies and others
  • Direct all contract compliance reporting activities and maintain the compliance dashboard
  • Direct efforts to communicate compliance programs, including written materials and training programs designed specifically to promote the understanding of compliance issues, laws and regulations, and consequences of non-compliance
  • Provide timely and relevant information on all aspects of compliance issues.
  • Review complaints, concerns, or questions relative to compliance issues, and provides consultative leadership and support to all entities as appropriate.
  • Ensure that audit controls and measurements for internal processes are working to ensure correct processes are in place for accurate, complete and compliant programs of Centene Companies/Plans.
  • Identify need or demand for new and existing policies and reviews such policies for consistency throughout the organization.
  • Audit to ensure that all Centene Companies/Plan policies and procedures are in compliance with state and federal laws
  • Monitors assurance that due care is used in delegation of authority to persons Centene knew or should have known to have a propensity to engage in illegal activity (ie., background checks)
  • Develop policies and procedures in collaboration with Corporate Compliance Committee, associated departments, legal counsel and approved by the CEO and Corporate Board of Directors
  • Educate employees, staff, and others on the standards and procedures as well as the compliance program itself
  • Lead new business implementations from a compliance and regulatory standpoint
Education/Experience: Bachelor’s degree in Business Administration, related field, or equivalent experience. 8+ years of experience in health care or managed care environment. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.Pay Range: $142,300.00 - $263,500.00 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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