Compliance Officer

This is a fully remote position, open to applicants in Washington.

📋 Description

• Ensure adherence to regulatory requirements set by Washington state and other governmental bodies concerning the health insurance sector, Centene Corporation, and its affiliated businesses.

• Guarantee that the Washington health plan and Centene Corporate meet both state and federal program regulations, insurance laws, compliance mandates for business entities, and state contract stipulations.

• Maintain and monitor legal statutes and regulations, contract documentation, amendments, and compliance strategies.

• Create policies, procedures, and processes to align with state law, federal law, contractual obligations, and industry standards.

• Oversee, manage, and execute compliance programs, including those addressing fraud, abuse, and HIPAA regulations.

• Advise various departments on compliance challenges and the implementation of new compliance mandates.

• Conduct compliance audits and formulate as well as execute corrective action plans.

• Report the status of corrective action plans to senior management and the Board of Directors.

• Establish strategic relationships with state legislative policymakers.

• Assist in state legislative public policy matters related to state insurance, Managed Care Organizations, Medicare, and Medicaid regulations and initiatives.

• Identify, assess, and analyze the repercussions of state legislative and regulatory developments.

• Provide guidance to management regarding the effects of legislative and regulatory changes.

• Represent senior management in committees, meetings, and seminars.

• Carry out additional responsibilities as assigned.

• Adhere to all organizational policies and standards.

⛳️ Requirements

• A Bachelor's Degree in Public Policy, Government Affairs, Business Administration, or a related field is required.

• A Master's Degree or a Law degree is preferred.

• A minimum of 8 years of experience in compliance program management and contract oversight is required.

• Comprehensive knowledge of state administrative codes and regulations.

• Familiarity with state insurance laws and regulations, particularly those governing managed care.

• Experience working with state and federal government agencies.

• Experience with accreditation organizations.

• Experience with participating provider agreements.

• Proficient in HIPAA and Third Party Administration (TPA) laws.

• Knowledge of credentialing regulations and prompt pay laws.

• Candidates must reside in the state of Washington.

• Willingness to travel throughout Washington state as necessary.

• Equivalent experience gained through relevant knowledge, responsibilities, and skills reflective of the position's level.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase program.

• Tuition reimbursement opportunities.

• Paid time off, including holidays.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.

• Additional incentives may be included in total compensation.

• Equal opportunity employer dedicated to diversity.