Senior Compliance and Vendor Management Oversight Specialist

Position Purpose

Leads the integrity and governance of Centene's and/or its vendors corporate ethics and compliance program, and ongoing oversight and analysis of regulatory compliance practices.

Key Details

• Flexible remote work option available in the Continental United States.

• Collaborates with internal teams and external vendors or subcontractors to promote contract compliance and uphold program integrity through structured oversight and monitoring of government-sponsored healthcare programs.

• Oversees the management of the entire contract lifecycle, from drafting to finalization, ensuring compliance and mitigating risks.

• Conducts reviews, audits, and assessments of vendor relationships to ensure adherence to Centene's and Government-sponsored health care program requirements.

• Collaborates with business owners and vendors to drive process improvements, maintaining integrity, and ensuring compliance with Government-sponsored healthcare program requirements.

• Leads the timely, consistent, and accurate communication of state and federal regulatory updates impacting Medicaid and Marketplace regulatory filings in collaboration with market and product compliance officers.

• Prepares, organizes, and packages subcontractor files for approval/notification.

• Develops clear, accurate, and timely written reports detailing oversight and monitoring findings and recommendations.

• Ensures all supporting documentation and workpapers meet Centene and department standards, including the inclusion of sufficient evidence to substantiate findings.

• Partners with internal departments and subcontractors to route compliance concerns to the appropriate channels for investigation and resolution.

• Supports regulatory notifications and documentation of approvals/notifications.

• Performs other duties as assigned.

• Complies with all policies and standards.

Requirements

• Bachelor's Degree in related field; or, equivalent experience.

• Master's Degree preferred.

• Juris Doctor (JD) preferred.

• 4+ years Managed Care/Health Insurance and knowledge of relevant legal and regulatory frameworks required.

• 2+ years Project oversight with demonstrated ability to drive implementation and influence others preferred.

• 2+ years Reading, analyzing, and interpreting State and Federal laws, rules and regulations preferred.

• 2+ years State Medicaid or government sponsored healthcare compliance preferred.

• HealthCare Compliance (CHC) preferred.

Pay

$70,100.00 - $126,200.00 per year

Benefits

• Competitive pay

• Health insurance

• 401K and stock purchase plans

• Tuition reimbursement

• Paid time off plus holidays

• A flexible approach to work with remote, hybrid, field or office work schedules.