Job Description
Note: The job is a remote job and is open to candidates in USA. PA Health & Wellness is part of Centene, a diversified national organization focused on transforming health in communities. They are seeking a Director of Compliance Program Administration to oversee compliance audits, coordinate policy development, and investigate suspected fraud within the health plan.
- 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
- Investigate instances of suspected fraud within the health plan and report to appropriate management and regulatory entities
- Assist management with enforcement and discipline in appropriate instances of non-compliance
- Regularly inform health plan’s Board of Directors of the status of and activities pertaining to compliance
- Performs other duties as assigned
- Complies with all policies and standards
- Skills
- Bachelor's degree in related field or equivalent experience
- 5+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits
- 2+ years experience in the development of compliance and fraud programs
- 2 years experience with overseeing implementation of contract requirements
- Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff
- 7+ years experience preferred in Compliance/ERM
- 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
- Company Overview
- Established to deliver quality healthcare in the state of Pennsylvania through local, regional and community-based resources, PA Health & Wellness is a Managed Care Organization and subsidiary of Centene Corporation (Centene). It was founded in 2016, and is headquartered in Camp Hill, Pennsylvania, USA, with a workforce of 501-1000 employees. Its website is https://www.pahealthwellness.com/.
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