Director, Duals-Compliance - Centene Corporation : Job Details

Oversees and supports the Dual Eligible Special Needs Plans (D-SNP) compliance functions. Ensures adherence to federal, state, and local regulatory requirements and contractual obligations. Responsible for leading the review and interpretation of regulatory guidance and D-SNP contract requirements, ensuring they are accurately understood and applied. It also involves managing internal monitoring and auditing activities to ensure alignment with the organization's compliance program, policies, and procedures. Leads internal investigations related to D-SNP compliance issues, developing and implementing corrective action plans, and contributing to the development and execution of compliance strategies and communications. Serves as key point of contract during external audits and regulatory reviews involving D-SNP contracts, ensuring timely and accurate responses and follow-up. Manages approval and submission of timely and accurate D-SNP State Medicaid Agency (SMAC) contract and regulator...Compliance, Director, Monitoring, Regulatory, Operations, Healthcare, Business Services, Health