Senior Compliance Analyst

This is a fully remote position, open to applicants in Florida, +7 more states.

📋 Description

• Support the maintenance of Centene Corporation’s Compliance Program.

• Offer regulatory interpretation and execute compliance reporting.

• Oversee special projects.

• Create and implement compliance auditing and monitoring strategies.

• Address external information requests essential for regulatory filings.

• Manage compliance reporting obligations and engage with state and federal regulatory agencies.

• Oversee ethics and compliance projects or implementations.

• Analyze and synthesize regulatory requirements to formulate policy and/or position statements.

• Assist in the administration of annual code of conduct attestation and remediation processes.

• Communicate state and federal regulations to both internal and external stakeholders.

• Provide development guidance and support compliance policies, procedures, and work instructions.

• Identify, analyze, and resolve compliance-related issues.

• Maintain and review regulatory documentation.

• Develop, produce, and deliver compliance training programs.

• Conduct periodic compliance audits, risk assessments, and ongoing compliance monitoring.

• Assist health plans in fostering relationships with regulatory agencies and addressing policy matters.

• Support management with interim health plan compliance officer duties.

• Coordinate the implementation of Compliance Committee policies.

• Act as a company-wide resource and liaison regarding policies, contract issues, communications, workflow, and quality improvement initiatives.

• For Pennsylvania Health & Wellness only: Monitor and identify non-compliance as well as fraud, waste, and abuse risks and trends.

• Convene operational leaders to ensure compliant end-to-end workflows for providers and members.

• Ensure fraud, waste, and abuse prevention, detection, and recoupment processes comply with regulatory requirements and the CHC Agreement.

• Lead the monthly PHW fraud workgroup and the quarterly MCO FWA report submission.

• Act as a PHW liaison to the DHS Bureau of Program Integrity and the OAG.

⛳️ Requirements

• Must have authorization to work in the U.S. without requiring employment-based visa sponsorship now or in the future.

• Bachelor’s degree in a relevant legal field or equivalent experience.

• Master’s degree or Juris Doctorate is preferred and may be considered in lieu of experience.

• A minimum of 3 years of relevant experience in compliance, privacy, and/or regulatory affairs.

• Experience in project management is essential.

• Familiarity with laws and/or regulations related to compliance, particularly HIPAA and state regulations.

• For Pennsylvania Health & Wellness only: Certification as a CFE (Certified Fraud Examiner) is required.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase plans available.

• Tuition reimbursement opportunities.

• Paid time off in addition to holidays.

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

• Additional incentive programs may be included in total compensation.

• Equal opportunity employer dedicated to diversity.