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Compliance Analyst II

Company: Centene Coproration
Location: San Rafael
Posted on: August 3, 2019

Job Description:

Description: Position Purpose: Maintain the compliance programs, guide special projects, provide regulatory interpretations, perform compliance reporting; and develop and implement compliance auditing and monitoring strategies Complete monthly summaries across all markets to report the timeliness and accuracy of report deliverable submissions to the health plans Identify and implement systematic process improvements across all markets for the review and submission of member and provider materials Serve as designated power-user for software applications used to track and manage report deliverables Lead audits to verify accuracy of provider contracts as tracked and reported in credentialing and claim systems Assist health plans in managing relationships with regulatory agencies and seek to resolve policy issues which may impact operations Perform and support periodic risk assessments and ongoing compliance monitoring activities Support the monitoring of and action taken in response to legal, contractual and regulatory changes that impact operations Coordinate the review of and resolution to compliance issues and concerns Communicate state and federal requirements to internal and external clients Coordinate, review and response to external requests for information required by the organization, including but not limited to State complaints and waste, abuse and fraud (WAF) reviews.

Keywords: Centene Coproration, San Rafael , Compliance Analyst II, Professions , San Rafael, California

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