Manager, Enterprise Compliance Corrections

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: Manages team within the Compliance Corrections department responsible for intake, triage, and reporting activities to ensure successful identification and remediation of non-compliance issues with Medicaid, Medicare, Marketplace, and Commercial regulatory requirements, contractual obligations, and Company policies and procedures. Supports data integrity and reporting related to the internal and external corrective action plan lifecycle. Ensures data quality, interprets non-compliance trends, and develops Corrections reporting methodology in conjunction with Compliance leadership.

• Manage initial investigations and stakeholder discussions related to reported potential issues of non-compliance and coordinate with Compliance Corrections leadership to support staffing assignments for long-term ownership of confirmed issues of non-compliance.
• Develops policies, procedures, and process to comply with federal program regulations, and any applicable state regulations.
• Develops reports and deliverables and make recommendations to management.
• Identifies recommendations that have a significant impact on organization goals and objectives.
• Appropriately influences management to improve performance and assist leadership in meeting organization goals.
• Assists management in driving business decisions based on data.
• Manages compliance reporting responsibilities and respond to inquiries from stakeholders and leaders within the organization.
• Assists in the identification, analysis, and resolution of compliance issues.
• Communicates program status to management and key stakeholders.
• Maintains trusted, collaborative relationships with leadership to promote an appropriate level of engagement in the Corrections process.
• Hires, manages, and develops direct reports that supports the organization mission.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor's Degree in Business Administration, Public Policy, Public Health, or Health Administration or related field; or equivalent experience required. Master's Degree in Business Administration, Public Policy, Public Health, or Health Administration or related field preferred.
• 4+ years Compliance experience, preferable in healthcare environment required.
• 1+ years Medicaid, Medicare or Commercial Managed Care experience required.
• 2+ years Supervisory or management experience preferred.
• Previous experience demonstrating effective interaction with federal and state regulatory agencies in a manage care or insurance environment preferred.

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act