Health Net, Inc.
Position Purpose: Develop, implement, and perform compliance auditing, monitoring and reporting activities based on established program, policies, and practices to ensure and maintain compliance with federal, state, and local regulatory and contractual requirements.Develop and maintain quality and compliance reports and dashboards
Review and analyze deliverables and data reports to ensure timeliness of submission and identify trends in performance and improvement opportunities
Perform and monitor audits, risk assessments and documentation activities to ensure compliance
Identify, investigate, and resolve compliance issues and develop corrective action plans to mitigate future risks
Serve as the \u201cgo to\u201d person for all compliance activities including training and awareness programs
Design, implement and improve regulatory documentation and processes to address compliance issues and concerns related to all federal and state regulatory requirements, contract requirements and company standards
Research new markets and primary source verification to determine licensure requirements and administer ongoing licensure maintenance
Assist with vendor activities, including documentation of all pre- and annual delegate oversight and on-going vendor oversight and partnership activities
Update management on the status and activities pertaining to compliance, contract deliverables and related activitiesMaintain detailed project documentation including meeting minutes, action items, issues lists, and risk management plans.Effectively communicate project status to all stakeholders.Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.Education/Experience: Bachelor\u2019s degree in health care administration, compliance or related field. 3 years of compliance experience. Experience with risk assessment requirements, auditing and reporting processes, action plans, and compliance training.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.
Health Net, Inc.
Website : https://www.healthnet.com
Health Net's mission is to help people be healthy, secure and comfortable.