Participates in the oversight of Centene's and/or its third parties/subcontractor's corporate ethics and compliance program
Conducts focused reviews and audit, oversight, and monitoring of activities to assess compliance with Centene's contractual and regulatory requirements
Collaborates with business owners and/or third parties/subcontractors to drive remediation and assist Centene and third parties/subcontractors to maintain integrity through oversight and monitoring
Intakes and triages compliance issues based on defined risk criteria and signs out to other team members as needed
Ensures adequate root cause analysis and development of corrective actions plans to effectively address non-compliance
Reviews and oversees progress towards remediation and documented key milestones in GRC tool
Identifies issues that require escalation and ensures they are addressed timely through established paths and processes
Conducts review of evidence to address root cause of issue and facilitate timely closure of issues
Supports corrections reporting providing meaningful trend analysis for business stakeholders and senior leadership

Bachelor's Degree in Managed Care/Health Insurance or related field; or equivalent experience required
3+ years of experience in Managed Care, Health Care, Health Insurance or related field required
1+ years experience in project oversight type role with demonstrated ability to drive implementation and influence others preferred
1+ years experience in reading, analyzing, and interpreting State and Federal laws, rules and regulations preferred
1+ years experience in State Medicaid or Federal managed care compliance preferred
Certified in HealthCare Compliance (CHC) preferred

Compliance Corrections Specialist

Key skills