Position Purpose: Ensure regulatory compliance with state and other government agencies related to the health insurance industry, Centene Corporation, and its business subsidiaries.
- Ensure business unit and Centene Corporate are in compliance with state and federal program regulations, insurance regulations, regulatory requirements for business entities and state contract requirements
- Maintain and track laws and regulations, contract documentations, amendments, and various compliance measures. Develop policies, procedures, and processes to comply with state law, federal law, contract requirements, and various standards
- Oversee, administer, and implement various compliance programs, including fraud and abuse and HIPAA
- 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, and report on achievement of action plans to senior management and Board of Directors
- Develop strategic relationships with state legislative policymakers and assist with the development of state legislative public policy concerning state insurance, Managed Care Organization, Medicare and Medicaid regulations and initiatives
- Identify, evaluate and analyze the impact of state legislative and regulatory issues and advise management concerning impact
- Represent senior management at various committees, meetings, and seminars