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SalaryYou 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.
Any offer of employment that materializes as a result of this job opportunity is contingent upon Centene and Virginia Total Care being selected to provide managed care Medicaid services, and executing a contract with the Commonwealth thereto, under Cardinal Care Managed Care (CCMC) RFP #13330.
Position Purpose:
- Conduct compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with local, state and regulatory requirements.
- Represent the key leadership position for compliance at the health plan, oversee communication, coordinate of policy development and ensure accurate and timely communication to all departments.
- Investigate instances of suspected fraud within the health plan and report to appropriate management and regulatory entities.
- Assist management with enforcement and discipline in appropriate instances of non •compliance.
- Regularly inform health plan’s Board of Directors of the status of and activities pertaining to compliance.
Education/Experience: Bachelor’s degree in related field or equivalent experience. 5+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits; 2+ years experience in the development of compliance and fraud programs; 2 years experience with overseeing implementation of contract requirements. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.Pay Range: $111,600.00 - $206,400.00 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.
