Vendor Operations Oversight Specialist (Medicare)

Vendor Oversight Program Manager

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose : Develop and conduct effective vendor oversight programs, in collaboration with key stakeholders, to assure vendor performance consistently meets regulatory requirements and internal business objectives

Responsibilities :

• Monitor vendor performance, including subsidiaries and external vendors, to assure performance is consistent with regulatory and business requirements
• Assure vendors have an effective self-monitoring programs that identify potential and / or actual performance issues
• Develop standardized processes for tracking and documenting all vendor oversight activities and reporting to key stakeholders
• Assure vendors develop, implement and complete corrective action plans to resolve identified deficiencies in compliance with regulatory and business requirements
• Serve as a subject matter expert on current CMS requirements for operational functions and vendor oversight
• Performs other duties as assigned
• Complies with all policies and standards

Education / Experience : Bachelor's degree in Healthcare, Business Administration or related field. 2+ years of combined managed care operations, compliance, auditing, project management, or business analysis experience, preferably within the Medicare field. Previous experience coordinating cross functional teams on large scale projects. Ability to evaluate, understand, and communicate regulatory and business requirements. Demonstrated understanding of relationships and dependencies between functional areas.

This position is remote within the state of New York. Candidates must reside in the state of New York to be considered. Quarterly in office meetings required.

Pay Range : $55,100.00 - $99,000.00 per year

Centene offers a comprehensive benefits package including : competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individuals skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act