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jobs description

Job 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, organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility...
• REMOTE POSITION – MUST BE IN CALIFORNIA within driving distance to Sacramento or Woodland Hills**

Position Purpose: Manage and implement strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company.
• Ensure all Medicare and Medicaid product and services are being tested for compliance with program regulations, insurance regulations, and regulatory requirements for business entities.
• Maintain and track laws and regulations, contract documentations, amendments, and various compliance measures.
• Develop policies, procedures, and process to comply with federal program regulations, and any applicable state regulations.
• Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract .
• Conduct compliance audits, develop and implement corrective action plans.
• Perform plan risk assessments and report emerging trends, deficiencies and variances, report findings to other departments and teams as appropriate.
• Provide required Ethics, Compliance, Risk Management, FWA, privacy, and security training for existing and new employees and as required non-employees.
• Oversee and ensure regulatory reports are monitored for submission

• Bachelors’ degree in related field or equivalent experience. Master's or Juris Doctorate degree .
• 4+ years of compliance experience, preferably in a healthcare environment with at least 2+ years of Medicaid, Medicare, or Commercial Managed Care experience.
• Previous experience demonstrating effective interaction with federal and state regulatory agencies in a managed care or insurance environment .
• Previous leadership experience strongly
• Intermediate to advanced Excel skills strongly

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 , and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to , , , , , gender , , , veteran status, or other characteristic protected by applicable law
Palos Verdes Estates CA United States


Apply - Manager, Ethics & Compliance Palos Verdes Estates