Compliance Analyst
Company: Sunshine State Health Plan
Location: Pembroke Pines
Posted on: September 12, 2024
Job Description:
You could be the one who changes everything for our 28 million
members. Centene is transforming the health of our communities, one
person at a time. As a diversified, national organization, you'll
have access to competitive benefits including a fresh perspective
on workplace flexibility.
Position Purpose: As part of Sunshine Health Plan's Payment
Integrity Compliance team, the Compliance Analyst will assist in
maintaining Centene Corporation's Compliance Program; guide special
projects; provide regulatory interpretation; perform compliance
reporting; and develop and implement compliance auditing and
monitoring strategies. *Note: Qualified candidates must reside in
Florida. This is a hybrid position as there is an in-person element
to the job. This will include traveling to the South Florida office
once a month for team/department meetings, trainings. Therefore,
candidates should be located in the greater South Florida area.
Essential Responsibilities:
- Respond to external requests for information required by the
organization for its regulatory filings.
- Respond to inquiries from state and federal regulatory
agencies.
- Monitor pending legislation and regulations affecting Centene
Corporation services.
- Maintain database and other reference materials related to
legislative and regulatory issues and compliance.
- Communicate state and federal requirements to internal and
external clients.
- Provide development guidance and assists in the identification,
implementation, and maintenance of compliance policies, procedures
and work instructions.
- Assist in the identification, analysis, and resolution of
compliance issues.
- Maintain and reviews regulatory documentation necessary to
maintain corporate standards.
- Assist in developing, producing and conducting compliance
training programs.
- Perform periodic compliance audits, risk assessments and
conducts related 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.
- Plan, direct and coordinate the implementation of Compliance
Committee policy to ensure decisions are properly executed.
- Serve as a company wide resource and liaison on policies,
contract issues and provisions, communications, workflow, and
quality improvements initiatives.Education/Experience: Bachelor's
degree in related field or equivalent experience. Master's or Juris
Doctorate degree preferred and may be considered in lieu of
experience. 1+ years of related experience in compliance, privacy
and/or regulatory affairs. Working knowledge of laws and/or
regulations in area of compliance; in particular HIPAA, and state
regulations.Pay Range: $54,000.00 - $97,100.00 per yearCentene
offers a comprehensive benefits package including: competitive pay,
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-related 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. 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.
Keywords: Sunshine State Health Plan, Weston , Compliance Analyst, Professions , Pembroke Pines, Florida
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