Senior Compliance Analyst – Duals Audit
Job Description:
• Partners with leadership in maintaining Centene Corporation's Compliance with Duals (D-SNP) Program requirements
• Provide regulatory interpretation, perform compliance reporting, lead special projects, and develop and implement compliance auditing and monitoring strategies for the D-SNPs
• Responds to external audit requests for information required by the organization for its Duals and SMAC regulatory filings
• Manages Duals (and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and respond to inquiries from state and federal regulatory agencies
• Leads Duals compliance projects or implementations
• Reviews and synthesizes Duals regulatory requirements and create policy and/or position statements
• Partners with leadership to manage annual SMAC assessment and tracking of caps
• Communicate Duals (state and federal) requirements to internal and external clients
• Provides development guidance and leads the identification, implementation, and maintenance of Duals and overlapping Medicare compliance policies, procedures and work instructions
• Leads the identification, analysis, and resolution of Duals compliance issues
• Maintains and reviews D-SNP regulatory documentation necessary to maintain corporate standards
• Partners with leadership in developing, producing and conducting Duals compliance training programs
• Perform periodic compliance audits, risk assessments and conducts related to ongoing Duals compliance monitoring activities
• Serves as a company-wide resource and liaison on Duals policies, SMAC items and provisions, communications, workflow, and quality improvements initiatives
• Performs other duties as assigned
• Complies with all policies and standards
Requirements:
• Bachelor's Degree in Law or related field; or equivalent experience required
• 4+ years Compliance and/or regulatory affairs required
• Experience in project management with working knowledge of laws and/or regulations in area of compliance, in particular Medicare, D-SNP, and state regulations required
Benefits:
• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• flexible approach to work with remote, hybrid, field or office work schedules
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