Compliance Specialist

Centene   •  

Columbus, OH

Industry: Healthcare IT

  •  

5 - 7 years

Posted 396 days ago

Description

 Position Purpose: Ensure compliance with contractual requirements and federal and state government reporting and regulations. Maintain government relations for compliance activities.

  • Ensure compliance with contract provisions with various agencies and applicable State and Federal laws
  • Serve as compliance resource for day–to-day processes
  • Analyze and determine the best course of action for each inquiry/problem
  • Act as primary contact for initiating and coordinating compliance projects
  • Develop and update plan policies and procedures to ensure compliance with federal and state requirements
  • Conduct periodic assessments and audits to ensure compliance with contractual and regulatory requirements and timeliness of submission
  • Oversee the day-to-day health plan policies and procedures to ensure federal and state regulatory compliance

 Qualifications

Education/Experience: Bachelor’s degree in related field or equivalent experience. 5+ years of compliance or regulatory experience. Advanced experience with Microsoft Office applications. Knowledge of business operations related to managed care preferred.

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