Centene Corporation Compliance & Reporting Specialist in Fresno, California

Description:

Position Purpose: Develop, implement, and perform compliance auditing, monitoring and reporting activities based on established program, policies, and practices to ensure and maintain compliance with federal, state, and local regulatory and contractual requirements.

  • Develop and maintain quality and compliance reports and dashboards
  • Review and analyze deliverables and data reports to ensure timeliness of submission and identify trends in performance and improvement opportunities
  • Perform and monitor audits, risk assessments and documentation activities to ensure compliance
  • Identify, investigate, and resolve compliance issues and develop corrective action plans to mitigate future risks
  • Serve as the go to person for all compliance activities including training and awareness programs
  • Design, implement and improve regulatory documentation and processes to address compliance issues and concerns related to all federal and state regulatory requirements, contract requirements and company standards
  • Research new markets and primary source verification to determine licensure requirements and administer ongoing licensure maintenance
  • Assist with vendor activities, including documentation of all pre- and annual delegate oversight and on-going vendor oversight and partnership activities
  • Update management on the status and activities pertaining to compliance, contract deliverables and related activities

Qualifications:

Education/Experience: Bachelor s degree in health care administration, compliance or related field. 3 years of compliance experience. Experience with risk assessment requirements, auditing and reporting processes, action plans, and compliance training.

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.

Job: Compliance

Organization: Envolve Pharmacy

Location: California-Fresno

Requisition ID: 1059989