Centene Corporation

Transforming the health of the communities we serve, one person at a time.

Manager, Compliance – Duals & D-SNP Product

ComplianceComplianceFull TimeRemoteTeam 10,001+Since 1984H1B No SponsorCompany SiteLinkedIn

Location

Florida + 3 moreAll locations: Florida, New York, Missouri, Tennessee

Posted

30 days ago

Salary

$87.7K - $157.8K / year

Bachelor Degree4 yrs expEnglish

Job Description

• Manage the Dual compliance department functions • regulatory and D-SNP contract review and interpretation • periodic monitoring and auditing activities based on established compliance program • policies and practices to ensure and maintain compliance with regulations • Manage approval and submission of timely and accurate D-SNP State Medicaid Agency contract and regulatory required report deliverables • Oversee all SMAC updates including creating new and updating existing SMACs with CMS, Health Plans, States and consultants/vendors • Conduct periodic assessments to ensure compliance against SMAC and regulatory requirements • Oversee creation and implementation of corrective action plans to reduce or eliminate risk • Collaborate with CMS, States, Product and Strategy • Manage composition and delivery of inquiries and responses to state regulatory agency about D-SNP inquiries • Support responses to “request for proposals” (RFPs) and new business implementations • Participate in new Duals business implementations • Design, implement and improve processes to prevent, detect and respond to compliance issues • Create and deliver Duals compliance training for all employees on an annual basis and as needed basis

Job Requirements

  • Bachelor's Degree Health Care Administration, Compliance or related field or equivalent experience required
  • 4+ years experience in compliance to include risk assessment against contract and regulatory requirements
  • creation and execution of auditing, monitoring and reporting processes
  • administration of correction action plans
  • implementation of written policies and procedures
  • developing and delivering compliance training and education required
  • Experience with D-SNP SMAC, regulatory requirements and/or operations required
  • Medicare managed health experience required.

Benefits

  • competitive pay
  • health insurance
  • 401K and stock purchase plans
  • tuition reimbursement
  • paid time off plus holidays
  • flexible approach to work with remote, hybrid, field or office work schedules

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