[Remote] Director, Compliance Program Administration

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/. Apply Now Apply Now