Easy JobSenior Compliance Administrator - Network, Provider, Product
Centene Corporation · Worldwide · Full-time · Remote
Position Purpose: Serves as an individual contributor and subject matter expert responsible for supporting the day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and applicable federal and state regulations. Provides trusted advisory support to business and compliance leadership by providing regulatory guidance, conducting research and analysis, tracking issues, contributing to audit readiness and supporting compliance workplan activities. This role partners closely with the Sr. Manager, Medicare Compliance Advisory, to ensure accurate interpretation of CMS requirements, timely completion of assignments, and consistent documentation of compliance risks, trends, and corrective actions.
• Execute the Medicare Compliance Program in alignment with CMS and applicable federal and state regulations, ensuring prevention, detection, and correction of noncompliance and FWA.
• Interprets and translates federal, state, and contractual requirements into clear, actionable compliance guidance for business stakeholders, ensuring consistent understanding and application across operations.
• Develops and coordinates regulatory communications, including responses to inquiries, issue summaries, and disclosures, while serving as a liaison with internal stakeholders and external regulators as appropriate.
• Supports the preparation, validation, and submission of regulatory reports, attestations, and filings, ensuring accuracy, completeness, and timeliness of all deliverables.
• Proactively identifies compliance risks and evaluates business processes to assess exposure, provide risk stratification, and recommend mitigation strategies.
• Leads or supports issue identification, root cause analysis, and development of corrective action plans to ensure effective and compliant resolution of identified gaps.
• Provides subject matter expertise to audit and monitoring activities, including supporting audit scope development, testing strateg