Compliance Oversight Specialist – Non Clinical

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

📋 Description

• Engage in the supervision of WellCare's and/or appointed subcontractors' corporate ethics and compliance initiatives

• Execute targeted reviews, audits, oversight, and monitoring to evaluate compliance with contractual and regulatory obligations

• Work together with business owners and delegated vendors to facilitate remediation efforts

• Support WellCare and its subcontractors in upholding integrity and adhering to Government-sponsored healthcare program standards

• Evaluate new and revised Government-sponsored healthcare program contracts and stipulations

• Identify and assess compliance risks within local Markets, corporate Shared Services, and/or delegated subcontractors

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

• Create formal written reports detailing oversight and monitoring findings along with recommendations

• Prepare workpapers following departmental standards and ensure adequate evidentiary support is maintained

• Refer compliance issues to the appropriate channels for investigation and resolution

• Review and assess corrective action plans while providing updates to stakeholders, Senior Management, Compliance Oversight Committees, and Board committees

• Participate in special projects, including training initiatives

• Carry out additional duties as assigned

• Adhere to all policies and standards

⛳️ Requirements

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

• Over 3 years of experience in Managed Care/Health Insurance

• Preferred: More than 1 year of experience in a project oversight capacity, showcasing the ability to drive implementation and influence others

• Preferred: More than 1 year of experience in reading, analyzing, and interpreting State and Federal laws, rules, and regulations

• Preferred: More than 1 year of experience in State Medicaid or Federal managed care compliance

• Certification in Healthcare Compliance (CHC) is preferred

🏝️ Benefits

• Competitive salary

• Health insurance coverage

• 401K retirement plan

• Stock purchase plans

• Tuition reimbursement options

• Paid time off in addition to holidays

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

• Commitment to equal opportunity employment