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, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: As part of Sunshine Health Plan's Payment Integrity Compliance team, the Compliance Analyst will assist in maintaining Centene Corporation’s Compliance Program; guide special projects; provide regulatory interpretation; perform compliance reporting; and develop and implement compliance auditing and monitoring strategies.

*Note: Qualified candidates must reside in Florida. This is a hybrid position as there is an in-person element to the job. This will include traveling to the South Florida office once a month for team/department meetings, trainings. Therefore, candidates should be located in the greater South Florida area.

Essential Responsibilities:

• Respond to external requests for information required by the organization for its regulatory filings.

• Respond to inquiries from state and federal regulatory agencies.

• Monitor pending legislation and regulations affecting Centene Corporation services.

• Maintain database and other reference materials related to legislative and regulatory issues and compliance.

• Communicate state and federal requirements to internal and external clients.

• Provide development guidance and assists 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 reviews 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 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.

• 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 field or equivalent experience. Master's or Juris Doctorate degree preferred and may be considered in lieu of experience. 1+ years of related experience in compliance, privacy and/or regulatory affairs. Working knowledge of laws and/or regulations in area of compliance; in particular HIPAA, and state regulations.Pay Range: $54,000.00 - $97,100.00 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.

Job Tags

Holiday work, Contract work, Remote job, Flexible hours,

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