Director, Medicare Regulatory Change Management
WFA Digital Insight
As the demand for healthcare regulatory experts grows, with a 25% increase in job postings in 2025, professionals with a strong background in compliance and Medicaid programs are in high demand. Centene Corporation's commitment to diversity and flexibility makes it an attractive employer. With 28 million members, the company's impact is significant, and candidates with a passion for regulatory change management can make a real difference. Before applying, candidates should be aware of the need for strong collaborative skills and the ability to communicate complex regulatory changes to key stakeholders.
Job Description
About the Role
The Director, Medicare Regulatory Change Management, plays a critical role in ensuring Centene Corporation's compliance with regulatory requirements for its Medicare products. This position entails developing and implementing strategies to maintain and implement regulatory requirements across the company. As a key leader, the Director will work closely with various departments, including Product Compliance Partners, Policy, Government Relations, and Legal, to assess and analyze impactful regulations and guidance.The role requires a deep understanding of healthcare regulatory agencies and the development of compliance and fraud programs. The Director will provide guidance to various departments regarding compliance issues and implementation of new compliance requirements. With a strong focus on collaboration, the Director will work with cross-functional teams to evaluate and monitor changes to service functions and performance in relation to the company's mission, philosophy, objectives, and policies.
What You Will Do
- Develop and implement strategies to ensure successful maintenance and implementation of regulatory requirements for assigned products
- Lead the maintenance and tracking of laws, regulations, and various compliance guidance documents
- Prepare regular updates and analysis on impactful regulatory actions
- Communicate key regulatory changes, trends, and data to key stakeholders and leaders throughout the company
- Collaborate with Product Compliance Partners, Policy, Government Relations, Legal, and other key departments to assess and analyze impactful regulations and guidance
- Evaluate and monitor changes to service functions and performance in relation to company mission, philosophy, objectives, and policies
- Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements
- Mentor and guide subordinates within the department as necessary
- Stay up-to-date with industry trends and regulatory changes, applying this knowledge to improve compliance and risk management
What We Are Looking For
- Bachelor's degree in a related field or equivalent experience
- 7+ years of combined compliance program management and contract experience with Medicare and Medicaid programs
- Experience with healthcare regulatory agencies in the development of compliance and fraud programs
- Experience with oversight of implementation of federal and state insurance or program requirements
- Strong understanding of regulatory requirements and compliance issues
- Excellent communication and collaboration skills
- Ability to analyze complex data and provide actionable insights
- Strong leadership and mentoring skills
Nice to Have
- Experience with internal and state audits
- Knowledge of contract language and regulatory requirements
- Certification in compliance or a related field
- Experience with project management and implementation of new compliance requirements
Benefits and Perks
- Competitive pay, with a salary range of 18,400 - $219,000 per year
- Comprehensive benefits package, including health insurance, 401K, and stock purchase plans
- Tuition reimbursement and paid time off plus holidays
- Flexible approach to work, with remote, hybrid, field, or office work schedules available
- Opportunities for professional growth and development
- Recognition and reward programs for outstanding performance
How to Stand Out
- To stand out in this role, highlight your experience with regulatory requirements and compliance issues in your application and during the interview process.
- Make sure to research Centene Corporation's values and mission, and be prepared to discuss how your skills and experience align with them.
- Develop a strong understanding of the company's products and services, and be prepared to discuss how you can contribute to their success.
- Consider obtaining certifications in compliance or related fields to demonstrate your expertise and commitment to the field.
- Be prepared to provide specific examples of your experience with compliance program management and contract experience with Medicare and Medicaid programs.
- Prepare thoughtful questions to ask during the interview, such as what the biggest challenges facing the team are and how you can contribute to solving them.
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