Compliance Oversight Specialist – Non Clinical

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

📋 Description

• Engage in the oversight of WellCare's and/or assigned subcontractors' corporate ethics and compliance initiatives.

• Execute targeted reviews, audits, oversight, and monitoring efforts to evaluate adherence to contractual and regulatory standards.

• Work together with business stakeholders and designated vendors to promote corrective actions.

• Support WellCare and its subcontractors in fulfilling Government-sponsored healthcare program obligations.

• Analyze new and modified Government-sponsored healthcare program contracts and requirements.

• Assist local Markets, corporate Shared Services, and subcontractors in identifying and evaluating compliance risks.

• Assess the effectiveness of compliance programs, policies, and procedures.

• Generate timely formal written reports detailing findings and recommendations.

• Prepare workpapers in compliance with departmental standards and maintain adequate evidentiary support.

• Channel compliance issues to appropriate avenues for investigation and resolution.

• Review and assess corrective action plans, providing follow-up to stakeholders, senior management, oversight committees, and the Board's Audit, Finance, and Regulatory Compliance Committee.

• Take part in special projects, including training initiatives.

• Perform additional duties as assigned.

• Adhere to all policies and standards.

⛳️ Requirements

• Bachelor's Degree in a relevant field, or an Associate's degree with 4 years of relevant experience, or a High School Diploma/GED with 5 years of relevant experience in place of a Bachelor's degree is required.

• Minimum of 3 years of experience in Managed Care/Health Insurance is required.

• At least 1 year of experience in a project oversight role with a proven ability to drive implementation and influence others is preferred.

• A minimum of 1 year of experience in reading, analyzing, and interpreting State and Federal laws, rules, and regulations is preferred.

• At least 1 year of experience in State Medicaid or Federal managed care compliance is preferred.

• Certification in HealthCare Compliance (CHC) is preferred.

• Must comply with all applicable policies and standards.

• Qualified candidates must meet relevant legal employment criteria.

🏝️ Benefits

• Competitive pay

• Health insurance

• 401K and stock purchase plans

• Tuition reimbursement

• Paid time off plus holidays

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

• Additional incentive options may be included in total compensation

• Accommodation support for candidates