Compliance Oversight Specialist – Non-Clinical

Role Overview

• Participates in the oversight of WellCare's and/or its delegated subcontractor's corporate ethics and compliance program
• ongoing oversight and analysis of regulatory compliance issues
• conducting focused reviews and audit
• oversight, and monitoring of activities to assess compliance with WellCare's contractual and regulatory requirements
• collaborates with business owners and/or delegated vendors to drive remediation and assist WellCare and delegated subcontractors to maintain integrity through oversight and monitoring and in meeting Government-sponsored health care program requirements
• assists in the assessment of new and amended Government-sponsored health care program contracts and requirements
• prepares accurate and timely formal written reports on oversight and monitoring activity findings and recommendations and ensure workpapers are properly prepared

Requirements

• A Bachelor's Degree in Related field required, or Associates with 4 years of applicable experience, or HSD/GED with 5 years of applicable experience in lieu of Bachelor’s degree
• 3+ years of experience in Managed Care/Health Insurance
• Preferred 1+ year of experience in project oversight type role with demonstrated ability to drive implementation and influence others
• Preferred 1+ year of experience in reading, analyzing, and interpreting State and Federal laws, rules and regulations
• Preferred 1+ year of experience in State Medicaid or Federal managed care compliance
• A license in one of the following is required: Preferred Other Certified in HealthCare Compliance (CHC)

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• flexible approach to work with remote, hybrid, field or office work schedules