Sunrise, FloridaApply NowJob ID 1128830Category ComplianceOrganization Sunshine State Health PlanSchedule Full-time Description:Position Purpose: Oversee all compliance functions for the health plan including communication and coordination of policy development. Oversee the accurate and timely submission of over contract deliverables for all lines of business and service delivery areas. Oversee the accurate and timely submission of all CMS Medicare SNP requirements Serve as senior leadership and single point of contact in all State compliance meetings and interactions. Manage direct correspondence and daily interaction with all state regulators. Serve as senior leadership in all Department of Insurance and HHSC audit processes. Managing all facets of the audit and communications. Serve as senior leadership in Enterprise Risk Management process working directly with corporate ERM and Executive Management team to ensure current evaluation and documentation of business risks. Conduct internal compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with federal, state and local regulatory requirements. Accountable for the management and oversight of compliance for all health plan material subcontractors to include directing the performance of annual oversight Qualifications:Education/Experience: Bachelors degree in related field. Master's degree preferred. 7+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits; 5-7 years of experience with health care regulatory agencies in development of compliance and fraud programs; 5+ years experience with overseeing implementation of contract requirements. 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. Search for a category, location, or category/location pair, select from the suggestions and click Add. Our local approach allows us to help members access high-quality, culturally sensitive healthcare services.
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