Experienced Medicare Compliance Officer – Leadership Role in Healthcare Compliance and Regulatory Affairs

Introduction to Centene and Our Mission

Centene is at the forefront of transforming the health of our communities, one person at a time. With a commitment to excellence and a passion for making a difference, we are dedicated to providing high-quality healthcare services to our 28 million members. As a leader in the healthcare industry, we recognize the importance of compliance and regulatory affairs in ensuring the integrity and effectiveness of our operations. That's why we're seeking an experienced and skilled Medicare Compliance Officer to join our team and play a critical role in promoting a culture of compliance and excellence throughout our organization.

Job Overview and Responsibilities

As a Medicare Compliance Officer at Centene, you will be a key member of our Medicare & Compliance Senior Leadership team, responsible for leading the Medicare Compliance team and developing a best-in-class Medicare Compliance Program that exceeds stakeholder expectations. Your expertise and leadership will be essential in ensuring that our organization remains compliant with all relevant laws, regulations, and standards, and that we maintain the highest level of integrity and ethics in all our operations.

Your key responsibilities will include:

• Leading the Medicare Compliance team with a collaborative mindset and demonstrated commitment to excellence
• Developing a best-in-class Medicare Compliance Program that exceeds stakeholder expectations
• Ensuring that Medicare Compliance reports are provided regularly to the CRECO, the Medicare Compliance Committee, the Medicare Senior Leadership team, and the A&CC of the Board
• Providing timely and practical advice regarding new guidance from federal and state regulators
• Ensuring that all Medicare Compliance policies and procedures are reviewed annually and revised, as necessary, to reflect relevant legal, regulatory, and administrative developments
• Creating and coordinating education and training programs to ensure that the Board, officers, employees, First Tier Downstream and Related Entities (FDRs), and other individuals and entities are knowledgeable about the Enterprise Ethics and Compliance Program, Centene's Business Ethics and Code of Conduct (Code), the Company's compliance policies and procedures, and applicable statutory, regulatory, and administrative requirements
• Facilitating a quarterly Medicare Compliance Risk Assessment and developing an annual Compliance work plan
• Chairing the quarterly Medicare Compliance Committee and ensuring appropriate reporting is provided to the Committee
• Developing and implementing methods and programs that encourage managers and employees to report, without fear of retaliation, good faith concerns regarding Medicare non-compliance and potential instances of fraud, waste, and abuse (FWA)
• Responding to reports of potential FWA, including the coordination of internal investigations with the Special Investigations Unit and the development of appropriate corrective or disciplinary actions

Essential Qualifications and Experience

To be successful in this role, you will need to have:

• A Bachelor's Degree, with a Juris Doctor (JD) from an accredited law school, and a strong academic record
• State bar admission preferred
• 5+ years of experience in a leadership role, with a proven track record of success in compliance and regulatory affairs
• 10+ years of Medicare Managed Care Compliance experience, with a deep understanding of the complex regulatory environment and the ability to navigate it effectively
• Experience in the managed care sector, ideally with rigorous professional training in a law firm, corporate legal or compliance department, and/or relevant government agency

Preferred Qualifications and Skills

In addition to the essential qualifications, we are looking for candidates who possess:

• Excellent leadership and management skills, with the ability to motivate and inspire teams to achieve exceptional results
• Strong analytical and problem-solving skills, with the ability to analyze complex data and develop effective solutions
• Excellent communication and interpersonal skills, with the ability to build strong relationships with stakeholders at all levels
• A strong understanding of the healthcare industry, with a focus on compliance and regulatory affairs
• Experience with audit and investigation procedures, with the ability to direct audits and investigations of FDRs and other areas or functions involved with Medicare Parts C or D plans

Career Growth Opportunities and Learning Benefits

At Centene, we are committed to the growth and development of our employees. As a Medicare Compliance Officer, you will have access to a range of training and development opportunities, including:

• Comprehensive compliance and regulatory training programs
• Leadership development programs, designed to help you build your skills and expertise as a leader
• Opportunities to work on high-profile projects and initiatives, with the potential to make a significant impact on the organization
• A collaborative and supportive work environment, with a team of experienced professionals who are passionate about compliance and regulatory affairs

Work Environment and Company Culture

At Centene, we pride ourselves on our commitment to diversity, equity, and inclusion. We believe that our differences are what make us stronger, and we are dedicated to creating a work environment that is inclusive and supportive of all employees. As a Medicare Compliance Officer, you will be part of a dynamic and fast-paced team, with a focus on collaboration, innovation, and excellence.

We offer a range of benefits and perks, including:

• Competitive pay and benefits package
• Flexible work arrangements, including remote and hybrid work options
• Comprehensive health insurance and wellness programs
• 401K and stock purchase plans, with a generous company match
• Tuition reimbursement and education assistance programs
• Paid time off and holidays, with a focus on work-life balance

Compensation and Perks

The salary range for this role is $227,400.00 - $431,900.00 per year, depending on experience and qualifications. In addition to your salary, you will be eligible for a range of benefits and perks, including those listed above.

Conclusion and Call to Action

If you are a motivated and experienced compliance professional, with a passion for leadership and a commitment to excellence, we encourage you to apply for this exciting opportunity. As a Medicare Compliance Officer at Centene, you will have the chance to make a significant impact on the organization, while developing your skills and expertise in a dynamic and fast-paced environment. Don't miss out on this opportunity to join our team and take your career to the next level. Apply now and take the first step towards a rewarding new role.

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