Job description

You could be the one who changes everything for our 26 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.

Position Purpose: Ensure compliance with contractual requirements and federal and state government reporting and regulations. Maintain government relations for compliance activities.

Create and manage the process for all policies related to provider claim payments and interactions with providers
Ensure new and existing policies and procedures are in compliance with the law and submit to the state for public review
Internally track polices and ensure requests for information are addressed
Train, educate, and coach team to ensure all correspondence to the state is accurate
Evaluate responses and evaluate for potential risks/concerns to be escalated, including health plan advisories, notices of monetary penalties, and notices of action from the Department of Health

Education/Experience: Bachelor’s degree in related field or equivalent experience. 5+ years of compliance or regulatory experience. Advanced experience with Microsoft Office applications. Knowledge of business operations related to managed care preferred.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.

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