Compliance Officer, Washington
Core
Ensure regulatory compliance for Washington state health plans and Centene Corporation with state/federal regulations, insurance laws, and contract requirements.
Role type
Senior compliance officer (health insurance)
Builds
Compliance programs, policies, and corrective action plans for health insurance operations
Domain
Health insurance / Washington state regulatory environment
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
compliance program management, contract administration, state insurance law knowledge, HIPAA compliance, fraud and abuse prevention, policy development, regulatory auditing, legislative relationship management
Preferred skills
Master's degree or Law degree, experience with Medicare/Medicaid regulations, Third Party Administration (TPA) laws
Technologies
N/A
Responsibilities
Maintain and track laws, regulations, and contract documentation; Develop policies and processes to comply with state/federal laws; Oversee and implement compliance programs including fraud/abuse and HIPAA; Conduct compliance audits and implement corrective action plans; Provide guidance to departments on compliance issues; Develop strategic relationships with state policymakers; Analyze impact of legislative/regulatory changes and advise management
Seniority
Senior, hands-on IC