Centene

Senior Compliance Corrections Specialist

$70,100.00 - $126,200.00 per yearFull-time · Remote-MO
✓ Verified live on the employer's own system · added 5 days ago
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Mid-level · 5+ yrs exp

Requirements

Education: Bachelor's degree or related field

Experience: 5+ years

Skills & tools

Root Cause AnalysisManagementTeam LeadershipMaintenanceTeachingData AnalysisMS Office

Benefits — mentioned in this posting

Health, dental & vision401(k) / retirementEquity / stockTuition / educationPaid time off
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Full job description

Position Purpose:

Participates in corrections process for all lines of business. Responsibilities include intaking and triaging suspected issues of non-compliance, entry of compliance issues into GRC tool and assignment/coordination of issues to corrections team members. Collaborates with compliance and business stakeholders to gather information, develop corrective action plans, identify and escalate barriers to progress and gather evidence of remediation. Updates GRC tool to support corrections reporting.

  • Collaborates with compliance and business stakeholders to ensure adequate root cause analysis and development of corrective actions plans to effectively address non-compliance.
  • Reviews and oversees progress towards remediation and documented key milestones in GRC tool.
  • Identifies issues that require escalation and ensures they are addressed timely through established paths and processes.
  • Conducts review of evidence to address root cause of issue and facilitate timely closure of issues.
  • Develops, implements and continually refines corrections reporting that provides meaningful trend analysis for business stakeholders and senior leadership on new, in progress and closed issues as well as regulatory sanctions.
  • Supports management in the development and maintenance of corrections processes and tools designed to effectively remediate compliance issues in a timely manner, ensure timely escalation and sustainable resolutions.
  • Educates, encourages, and assists those within the company to maintain integrity through correction of identified non-compliance in order to meet the requirements of Government-sponsored health care programs.
  • Performs other duties as assigned
  • Complies with all policies and standards
Education/Experience:
  • Bachelor's Degree Managed Care/Health Insurance or related field, or equivalent experience required
  • 5+ years experience in Managed Care/Health Insurance or related experience required
  • Experience with data analytics preferred
  • Excellent Microsoft Office skills preferred
Licenses/Certifications:

Certified in HealthCare Compliance (CHC) preferred

Certified Compliance & Ethics Professional (CCEP) 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Pay Range: $70,100.00 - $126,200.00 per year

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This posting was published by Centene on their own careers system and is shown here with a direct link to apply there. Employers: for corrections or removal, contact jobs@veritahire.com.