Centene Corporation Policy Specialist in Rancho Cordova, California

ProfessionalPosition Purpose: Maintain operational policies, procedures and workflows to ensure compliance with the state, CMS and accrediting body regulations and standards. Review and make necessary updates to policies, procedures and work processes to maintain compliance with various agencies and regulations, including contract, CMS and accreditation requirementsEnsure all new and amended policies are operational within the assigned business unitsAssist with the creation of readiness documents and various policiesAssist the Compliance department with completions of URAC certification applications and renewalsServe as a subject matter expert on business practices, policy changes, and various guidelines to assist in defining business needsMonitor pending legislation and regulations affecting CenpaticoMaintain database and other reference materials related to legislative and regulatory issues and compliance.Communicate state and federal requirements to internal and external clientsProvide development guidance and assists in the identification, implementation, and maintenance of compliance policies, procedures and work instructions.Maintain and review regulatory documentation necessary to maintain corporate standardsAssist in developing, producing and conducting compliance training programsPerform periodic compliance audits, risk assessments and conducts related ongoing compliance monitoring activitiesAssist health plans in managing relationships with regulatory agencies and seek to resolve policy issues which may negatively impact service to membersPlan, direct and coordinate the implementation of Policy Committee to ensure decisions are properly executedServe as a company-wide resource and liaison on policies and workflow initiativesEducation/Experience: Bachelor’s degree in related field or equivalent experience. 3+ years of managed care experience. Experience writing and maintaining policies and procedures preferred. Strong written and verbal communication skills.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

TITLE: Policy Specialist

LOCATION: Rancho Cordova, California

REQNUMBER: 1098274

COMPANY: Compliance

POSITION TYPE: Professional

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.