Senior Compliance Analyst (Medical Loss Ratio)

Remote, USA Full-time
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. ​ Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States. Position Purpose: 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 Education/Experience: • 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. Pay Range: $70,100.00 - $126,200.00 per year Centene 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Apply tot his job
Apply Now

Similar Jobs

Noncredit Allied Health Instructor: Medical Coding and Billing

Remote, USA Full-time

Medical Coding Team

Remote, USA Full-time

Hospital medical Coder-ICD-10/CPT-(CA, OR, WA,HI)

Remote, USA Full-time

CERTIFIED MEDICAL CODER (CPC) Remote in TN, GA, OH or FL only

Remote, USA Full-time

Certified Medical Coder- Remote

Remote, USA Full-time

HCC Risk Adjustment Coder - Full Time - Remote

Remote, USA Full-time

[Hiring] Medical Coder @UnitedHealth Group

Remote, USA Full-time

Compliance Analyst (medical coding audit & documentation)

Remote, USA Full-time

Clinical Coder - Trauma (REMOTE)

Remote, USA Full-time

Remote Healthcare Coder jobs – Full‑Time Medical Coding Specialist in Sunrise, Florida – Medicare & CPT Expertise – $55 k‑$75 k Salary – Part‑Time Flex Option

Remote, USA Full-time

Part-Time Remote Data Entry Specialist – CVS Part-Time Opportunity for Accuracy and Efficiency

Remote, USA Full-time

Experienced Data Scientist for Innovative AI and Data Analysis Solutions – Part Time/Remote Opportunities at arenaflex

Remote, USA Full-time

Penetration Tester- Contract (Remote)

Remote, USA Full-time

Remote Customer Experience Associate – Compassionate Health & Nutrition Support Specialist (Work‑From‑Home)

Remote, USA Full-time

Manager, HCE - Remote

Remote, USA Full-time

Data Platform Engineer (Python)

Remote, USA Full-time

Anesthesia Scheduler

Remote, USA Full-time

Remote Regional Genetic Program Counselor - Texas Region

Remote, USA Full-time

Experienced Full Stack Data Entry Specialist – Remote blithequark Operations Support and Administration Expert

Remote, USA Full-time

Experienced Overnight Remote Customer Service Representative – Delivering Exceptional Support from Home with blithequark

Remote, USA Full-time
Back to Home