Senior Manager, Ethics & Compliance at Buckeye Community Health Plan

You could be the one who changes everything for our 28 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.

Applicants in this role must reside in the Columbus, Ohio area and come into the office every Wednesday.

Position Purpose: Manage and implement strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company.

• Lead Vendor Oversight and Management process, including Contract review, regulatory communications and submissions, and tracking vendor performance.
• Ensure all Medicare and Medicaid product and services are being tested for compliance with program regulations, insurance regulations, and regulatory requirements for business entities.
• Maintain and track laws and regulations, contract documentations, amendments, and various compliance measures.
• Develop policies, procedures, and process to comply with federal program regulations, and any applicable state regulations.
• Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language.
• Conduct compliance audits, develop and implement corrective action plans.
• Perform plan risk assessments and report emerging trends, deficiencies and variances, report findings to other departments and teams as appropriate.
• Provide required Ethics, Compliance, Risk Management, FWA, privacy, and security training for existing and new employees and as required non-employees.
• Provide mentoring and guidance to subordinates within the department as necessary.
• Serve as primary backup to department lead as necessary.

Knowledge/Experience:

• Bachelors’ degree in related field or equivalent experience. Master's or Juris Doctorate degree highly preferred.
• 5+ years of compliance experience, preferably in a healthcare environment with at least 3+ years of Medicaid, Medicare or Commercial Managed Care experience. Previous experience demonstrating effective interaction with federal and state regulatory agencies in a managed care or insurance environment preferred.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

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.