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Centene Corporation · 2 months ago

Senior Compliance Analyst, Duals (D-SNP) Products

United States

Full-time

Remote

Mid, Senior Level

$70K/yr - $126K/yr

4+ years exp

Centene Corporation is transforming the health of communities across the nation. The Senior Compliance Analyst will partner with leadership to maintain compliance with Duals (D-SNP) Program requirements, perform compliance reporting, and develop auditing and monitoring strategies for the programs.

Hospital & Health Care

Responsibilities

Responds to external 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

Partners with Duals Manager and health plans in managing relationships with regulatory agencies and seek to confirmation and clarification of D-SNP requirements and implementations where needed

Performs interim Duals Compliance manager responsibilities to include supporting the health plan compliance officer with D-SNP specific responsibilities. Serve as a company-wide resource and liaison on policies, contract issues and provisions, communications, workflow, and quality improvements initiatives

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

Qualification

Compliance lawsMedicare regulationsD-SNP knowledgeRegulatory affairsPolicy developmentCompliance auditingProject managementAnalytical skillsCommunication skillsTeam collaboration

Required

Bachelor's Degree 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