Senior Compliance Analyst - Claims

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: Assist in maintaining Centene Corporation’s Compliance Program. Provide regulatory interpretation, perform compliance reporting, lead special projects, and develop and implement compliance auditing and monitoring strategies.

• Respond to external requests for information required by the organization for its regulatory filings.
• Manage compliance reporting responsibilities and respond to inquiries from state and federal regulatory agencies.
• Manage ethics and compliance projects or implementations.
• Review and synthesize regulatory requirements and create policy and/or position statements.
• Assist in managing annual code of conduct attestation and remediation.
• Communicate state and federal requirements to internal and external clients.
• Provide development guidance and assist in the identification, implementation, and maintenance of compliance policies, procedures and work instructions.
• Assist in the identification, analysis, and resolution of compliance issues.
• Maintain and review regulatory documentation necessary to maintain corporate standards.
• Assist in developing, producing and conducting compliance training programs.
• Perform periodic compliance audits, risk assessments and conducts related to ongoing compliance monitoring activities.
• Assist health plans in managing relationships with regulatory agencies and seek to resolve policy issues which may negatively impact service to members.
• Assist management with interim health plan compliance officer responsibilities.
• Plan, direct and coordinate the implementation of Compliance Committee policy to ensure decisions are properly executed.
• Serve as a company-wide resource and liaison on policies, contract issues and provisions, communications, workflow, and quality improvements initiatives.

Education/Experience:

• Bachelor’s degree in related legal field or equivalent experience. Master’s or Juris Doctorate degree preferred and maybe considered in lieu of experience.
• 3+ years of related experience in compliance privacy and/or regulatory affairs.
• Experience in project management with working knowledge of laws and/or regulations in area of compliance, in particular HIPAA, and state regulations.

Pay Range: $68,700.00 - $123,700.00 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.

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