Senior Compliance Analyst, Medical Loss Ratio

Job Description: • Assist in maintaining Centene Corporation’s Medical Loss Ratio Compliance Program • Provide regulatory interpretation, perform compliance reporting, lead special projects, and develop and implement compliance medical loss ratio auditing and monitoring strategies • Respond to external requests for information required by the organization for its medical loss ratio regulatory filings • Manage compliance oversight or medical loss ratio reporting and assist in respond to inquiries from state and federal regulatory agencies • Manage ethics and compliance medical loss ratio projects or implementations • Review and synthesize regulatory requirements and create policy and/or position statements • Communicate state and federal requirements to internal and external clients • Provide development guidance and assist in the identification, implementation, and maintenance of compliance policies, procedures and work instructions • Assist in the identification, analysis, and resolution of medical loss ratio compliance issues • Maintain and review medical loss ratio regulatory documentation necessary to maintain corporate standards • Perform periodic compliance audits, risk assessments and conducts related to 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 • Serve as a company-wide resource and liaison on medical loss ratio policies, contract issues and provisions, communications, workflow, and quality improvements initiatives Requirements: • Bachelor’s degree in related legal field or equivalent experience • Master’s or Juris Doctorate degree preferred and maybe considered in lieu of experience • 3+ years of related experience in compliance privacy and/or regulatory affairs • Experience in project management with working knowledge of laws and/or regulations in area of compliance, in particular HIPAA, and state regulations 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 Apply tot his job