Centene Corporation
Centene Corporation is a Fortune 500, mission-driven healthcare leader committed to transforming the health of the communities we service, one person at a time.
Senior Compliance Analyst, Medical Loss Ratio
Location
Missouri
Posted
70 days ago
Salary
$70.1K - $126.2K / year
Seniority
Senior
Bachelor Degree3 yrs expExperience acceptedEnglish
Job Description
• Assist in maintaining Centene Corporation’s Medical Loss Ratio Compliance Program
• Provide regulatory interpretation, perform compliance reporting, lead special projects, and develop and implement compliance medical loss ratio auditing and monitoring strategies
• Respond to external requests for information required by the organization for its medical loss ratio regulatory filings
• Manage compliance oversight or medical loss ratio reporting and assist in respond to inquiries from state and federal regulatory agencies
• Manage ethics and compliance medical loss ratio projects or implementations
• Review and synthesize regulatory requirements and create policy and/or position statements
• Communicate state and federal requirements to internal and external clients
• Provide development guidance and assist in the identification, implementation, and maintenance of compliance policies, procedures and work instructions
• Assist in the identification, analysis, and resolution of medical loss ratio compliance issues
• Maintain and review medical loss ratio regulatory documentation necessary to maintain corporate standards
• Perform periodic compliance audits, risk assessments and conducts related to ongoing compliance monitoring activities
• Assist health plans in managing relationships with regulatory agencies and seek to resolve policy issues which may negatively impact service to members
• Serve as a company-wide resource and liaison on medical loss ratio policies, contract issues and provisions, communications, workflow, and quality improvements initiatives
Job Requirements
- Bachelor’s degree in related legal field or equivalent experience
- Master’s or Juris Doctorate degree preferred and maybe considered in lieu of experience
- 3+ years of related experience in compliance privacy and/or regulatory affairs
- Experience in project management with working knowledge of laws and/or regulations in area of compliance, in particular HIPAA, and state regulations
Benefits
- competitive pay
- health insurance
- 401K
- stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Related Guides
Related Categories
Related Job Pages
More Compliance Jobs
Grievance & Appeals Regulatory Nurse
IEHPInland Empire Health Plan is the largest not-for-profit Medi-Cal & Medicare health plan in the Inland Empire.
Compliance71 days ago
Full TimeRemoteTeam 1,001-5,000Since 1995H1B No Sponsor
Grievance & Appeals Regulatory Nurse dealing with member grievances for IEHP
Compliance71 days ago
Full TimeRemoteTeam 1,001-5,000Since 2008H1B No Sponsor
General Risk & Compliance Manager ensuring regulatory obligations in fintech payments
Director, Trade Compliance – North America, Oceania & APAC
Nextracker Inc.Powering what's next in energy.
Compliance71 days ago
Full TimeRemoteTeam 1,001-5,000Since 2013
Director of Trade Compliance leading a global program for Nextpower.
ERPOracle
California
Compliance71 days ago
Full TimeRemoteTeam 51-200Since 2012H1B No Sponsor
Compliance Engineer managing CMMC compliance and technical security controls.
AzureFirewalls



