[Remote] Director, Compliance Program Administration
Note: The job is a remote job and is open to candidates in USA. PA Health & Wellness is part of Centene, a diversified national organization focused on transforming health in communities. They are seeking a Director of Compliance Program Administration to oversee compliance audits, coordinate policy development, and investigate suspected fraud within the health plan.
Responsibilities
• Conduct compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with local, state and regulatory requirements
• Represent the key leadership position for compliance at the health plan, oversee communication, coordinate of policy development and ensure accurate and timely communication to all departments
• Investigate instances of suspected fraud within the health plan and report to appropriate management and regulatory entities
• Assist management with enforcement and discipline in appropriate instances of non-compliance
• Regularly inform health plan’s Board of Directors of the status of and activities pertaining to compliance
• Performs other duties as assigned
• Complies with all policies and standards
Skills
• Bachelor's degree in related field or equivalent experience
• 5+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits
• 2+ years experience in the development of compliance and fraud programs
• 2 years experience with overseeing implementation of contract requirements
• Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff
• 7+ years experience preferred in Compliance/ERM
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
Company Overview
• Established to deliver quality healthcare in the state of Pennsylvania through local, regional and community-based resources, PA Health & Wellness is a Managed Care Organization and subsidiary of Centene Corporation (Centene). It was founded in 2016, and is headquartered in Camp Hill, Pennsylvania, USA, with a workforce of 501-1000 employees. Its website is https://www.pahealthwellness.com/.
Apply Now
Apply Now
Responsibilities
• Conduct compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with local, state and regulatory requirements
• Represent the key leadership position for compliance at the health plan, oversee communication, coordinate of policy development and ensure accurate and timely communication to all departments
• Investigate instances of suspected fraud within the health plan and report to appropriate management and regulatory entities
• Assist management with enforcement and discipline in appropriate instances of non-compliance
• Regularly inform health plan’s Board of Directors of the status of and activities pertaining to compliance
• Performs other duties as assigned
• Complies with all policies and standards
Skills
• Bachelor's degree in related field or equivalent experience
• 5+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits
• 2+ years experience in the development of compliance and fraud programs
• 2 years experience with overseeing implementation of contract requirements
• Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff
• 7+ years experience preferred in Compliance/ERM
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
Company Overview
• Established to deliver quality healthcare in the state of Pennsylvania through local, regional and community-based resources, PA Health & Wellness is a Managed Care Organization and subsidiary of Centene Corporation (Centene). It was founded in 2016, and is headquartered in Camp Hill, Pennsylvania, USA, with a workforce of 501-1000 employees. Its website is https://www.pahealthwellness.com/.
Apply Now
Apply Now