Centene Corporation • Columbia, SC 29240
Job #2680904991
Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.
Position Purpose: Ensure regulatory compliance with state and other government agencies related to the health insurance industry, Centene Corporation, and its business subsidiaries.
Ensure business unit and Centene Corporate are in compliance with state and federal program regulations, insurance regulations, regulatory requirements for business entities and state contract requirements
Maintain and track laws and regulations, contract documentations, amendments, and various compliance measures. Develop policies, procedures, and processes to comply with state law, federal law, contract requirements, and various standards
Oversee, administer, and implement various compliance programs, including fraud and abuse and HIPAA
Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language
Conduct compliance audits, develop and implement corrective action plans, and report on achievement of action plans to senior management and Board of Directors
Develop strategic relationships with state legislative policymakers and assist with the development of state legislative public policy concerning state insurance, Managed Care Organization, Medicare and Medicaid regulations and initiatives
Identify, evaluate and analyze the impact of state legislative and regulatory issues and advise management concerning impact
Represent senior management at various committees, meetings, and seminars
Education/Experience: Bachelor's degree in Public Policy, Government Affairs, Business Administration or related field. 8+ years of compliance program management and contract experience. Extensive knowledge of state administrative code and regulations, state insurance laws and regulations including managed care regulations. Experience with state and federal government agencies, accreditation bodies, participating provider agreements, HIPAA and Third Party Administration (TPA) laws, credentialing regulations and prompt pay laws. Master's or Law degree preferred.
For Absolute Total Care Health Plan: Must reside in South Carolina.
Pay Range: $170,300.00 - $323,300.00 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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