Manager Ethics & Compliance - (KM11115)

Centene Corporation provides multi-line managed care programs and related services to individuals receiving benefits in Medicaid, including Supplemental Security Income (SSI) and the State Children's Health Insurance (SCHIP). Centene operates health plans in seven states. In addition, the Centene contracts with other healthcare organizations to provide specialty services including behavioral health, disease management, nurse triage and treatment compliance.

POSITION PURPOSE: Perform duties to assist the Corporate Compliance Officer and the Director of Ethics & Compliance to lead aspects of compliance functions of the organization and affiliated entities, serve as the organization's privacy officer, manage the compliance reporting function, aid in formulating and administering organization policies and procedures, and participates in business development opportunities for the company.

POSITION QUALIFICATION REQUIREMENTS:
Knowledge/Experience: Knowledge/Experience: Knowledge of a specialized or technical field such as management, privacy, public policy, government affairs. Equivalent to a four (4) year college education. Advanced degree preferred. Over two (2) years and up to and including five (4) years of management and government affairs experience. Extensive knowledge of regulations pertaining to privacy (i.e., Health Insurance Portability and Accountability Act, Family Educational Rights and Privacy Act, and Privacy Act of 1974). Experience in a managed care or insurance environment preferred.

Skills/ Competencies: Apply principles of logical or scientific thinking to define problems, collect data, establish facts, and draw valid conclusions. Deal with several abstract and concrete variables. Perform advanced functions of mathematics, algebra and statistics. Apply mathematical operations to frequency distributions, reliability and validity of tests, normal curve, analysis of variance, correlation techniques and factor analysis. Strong report and technical writing, comparative analysis and presentation skills needed, as well as the ability to manage multiple projects simultaneously. Perform reading, writing and speaking at an advanced level. Read periodicals, journals, manuals. Prepare business letters, expositions, summaries and reports using prescribed format and conforming to all rules of punctuation, grammar, diction and style. Participate in panel discussions and debates, and speak on a variety of subjects. Ability to use computer systems for the management, reporting and presentation of information, as well as correspondence. Ability to travel.

PRINCIPAL FUNCTIONS & ACCOUNTABILITIES:
Privacy: Serve as the organization's privacy officer, responsible for on-going develop and refinement of the privacy program. This includes, but is not limited to: Creates, reviews and revises policies and procedures associated with the organization's privacy practices. Provide guidance and assists in the identification, implementation, and maintenance of policies, procedures, work instructions, and other materials. Assists in developing, producing and conducting training programs, with the goal of promoting a consistent infrastructure and approach to all drivers. Investigating privacy issues and mitigating any potential violation of the privacy regulations. Gather pertinent information, identify and evaluate options, and recommend a course of action in regards to compliance issues. Prepare reports by researching, analyzing and summarizing information. Monitors legislation, guidance and regulations affecting the organization's privacy practices. Maintains awareness of industry trends and legislative impact on practices, policies and procedures. Provides technical support and guidance to other team members as needed.
Leadership: Confer with Corporate Compliance Officer and Director of Ethics and Compliance to review achievements and discuss required changes in goals or objectives resulting from current status and conditions. Develop, implement and maintain production and quality standards for the compliance program with a focus on privacy.
Auditing, Needs Analysis and Planning: Performs periodic audits, risk assessments and conducts related ongoing compliance monitoring activities. Evaluates and implements changes to service functions and performance in relation to company mission, philosophy objectives and policies.
Strategic Planning: Provides support in the planning and implementation of compliance with federal and state legislation. Plans, directs and coordinates implementation to ensure Committee policy decisions are executed within operations and administration. Participate in formulating and administering company policies and developing long-range goals and objectives for the privacy/compliance program. In support of the company's strategic plan, establish the department's strategic vision, objectives and attendant policies and procedures for the organization. Partner with business unit leaders to identify and prioritize needs of the organization. Evaluate current procedures and practices for accomplishing the organization and department's objectives to develop and implement improved procedures and practices and to ensure compliance with all related laws, regulations and executive orders.
Standardize Applications and Processes: Research and incorporate best practices into operations. Assures that department functions and responsibilities are coordinated with other operating departments of Corporate and subsidiary businesses.
Cross-Functional Activities: Chair, participate in, attend, and plan/coordinate, staff, departmental, committee, sub-committee, community, and other activities, meetings and seminars related to the compliance program. Serve on the corporate compliance committee, as well as directing special projects or studies.


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