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Senior Compliance Administrator

Company: Sunshine State Health Plan
Location: Tallahassee
Posted on: July 3, 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, a subsidiary of Centene, you'll design and implement programs, policies, and practices to ensure State and Federal program contract compliance, as well as compliance with federal and state legal and regulatory requirements primarily focusing on our Ambetter marketplace product. Represent the Health Plan (Sunshine Health Plan) at meetings with the State Department of Medicaid and the State Department of Insurance, helping to shape policy.Note: Qualified candidates must reside in Florida. This position is remote, but may require travel into an office for department meetings, etc.Essential 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.
  • Assist management with enforcement and discipline in appropriate instances of non-compliance.
  • Coordinate filings with the State Department of Medicaid and State Department of Insurance.
  • Serve as the lead for compliance review of member and provider materials.
  • May modify procedures or processes, undertake fact gathering and investigation activity to monitor the effectiveness of implementation.Education/Experience:
    • Bachelor's degree in healthcare administration, compliance or related field.
    • 6+ years of compliance and/or regulatory experience in a health care and/or managed care setting/organization.
    • Previous experience as a lead in a functional area, managing cross functional teams on large scale projects.
    • Familiarity of health exchange / marketplace product strongly preferred.
      Pay Range: $84,300.00 - $151,700.00 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, Tallahassee , Senior Compliance Administrator, Other , Tallahassee, Florida

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