Join Today: Medicare Compliance Officer
Start your career journey with us! We have an easy-to-learn role for a Medicare Compliance Officer! This position offers a hybrid work model, combining remote work with time in our Remote office. This position requires a strong and diverse skillset in relevant areas to drive success. We offer a competitive compensation package, with a salary of a competitive salary.
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Centene is transforming the health of our communities one person at a time. As an Executive on reputed company, you could be the one who changes everything for our 28 million members. Position Purpose: This position will be a member of Medicare & Compliance Senior Leadership, chairs Centene's Medicare Compliance Committee, attends meetings of the Enterprise Compliance Committee (ECC), and does not have financial, operational, or other non-compliance duties. This position is expected to promote an appropriate "Tone at the Top" of the organization with a commitment to service leadership.  Leading the Medicare Compliance team with a collaborative reputed company 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  Through appropriate designees, ensuring that colleagues receive timely and practical advice regarding new guidance from federal and state regulators ensuring that reputed company Medicare Compliance policies and procedures are reviewed annually and revised, as necessary, to reflect relevant legal, regulatory, and administrative developments and to address any compliance concerns or gaps that have been identified  Creating and coordinating, by appropriate delegation as warranted, education training program to ensure that the Board, officers, employees, First Tier reputed company and reputed company Entities (FDRs), and other individuals and entities are knowledgeable about the Enterprise Ethics and Compliance Program, CenteneÂs Business Ethics and Code of Conduct (Code), the CompanyÂs 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  Ensuring, by appropriate delegation as warranted, that reputed company applicable government exclusion lists, including, but not limited to those issued by the Office of Inspector General, U.S. reputed company and the Government Services Administration are screened monthly with respect to reputed company Board members, employees and FDRs and that any identified personnel issues are promptly addressed in accordance with applicable policies and procedures  Maintaining documentation for each report of potential non-compliance or potential FWA received from any reputed company, through any reporting channel or mechanism  Overseeing the development and implementation of Corrective Action Plans  Coordinating potential fraud investigations and referrals from and with the SIU, where applicable, and the appropriate National Benefit reputed company Medicare Drug reputed company Contractor  As appropriate and in coordination with the SIU, collaborating with other sponsors, State Medicaid programs, Medicaid Fraud Control Units, commercial payers, and other organizations reputed company a potential FWA issue is discovered that involves multiple parties  Ensuring that data and other information and materials submitted to CMS are accurate and in compliance with CMS reporting requirements  Reporting potential FWA to CMS, its designees and other regulatory and enforcement agencies  Directing, through one or more designees, audits and investigations of FDRs  Directing, through one or designees, audits of any area or function involved with Medicare Parts C or D plans  Interviewing, personally or through designees, employees and other relevant individuals regarding Medicare compliance issues  Performs other duties as assigned  Complies with reputed company policies and standards Education/Experience: Bachelor's Degree required: Juris Doctor (JD) from an accredited law school, with a strong academic record and a state bar admission preferred 5+ years of experience in a leadership role required 10+ years of Medicare Managed Care Compliance experience required Experience in the managed care sector preferred, ideally with rigorous professional training in a law firm, corporate legal or compliance department and/or relevant government agency preferredPay Range: $227,400.00 - $431,900.00 per year Centene offers a comprehensive benefits package including: reputed company, 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-reputed company 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. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Apply Job!Â
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