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Centene Corporation · 5 hours ago

Senior Compliance Analyst, Duals Audit

United States

Full-time

Remote

Mid, Senior Level

$70K/yr - $126K/yr

4+ years exp

Centene Corporation is a diversified, national organization transforming the health of communities. The Senior Compliance Analyst will partner with leadership to maintain compliance with Duals Program requirements, perform compliance reporting, lead special projects, and develop compliance auditing strategies.

Hospital & Health Care

Responsibilities

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

Qualification

ComplianceRegulatory AffairsMedicare RegulationsD-SNP KnowledgePolicy DevelopmentRisk AssessmentProject ManagementTraining Programs

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