Senior Compliance Analyst; Medical Loss Ratio

Position Purpose

Assist in maintaining Centene Corporation’s Medical Loss Ratio Compliance Program. Provide regulatory interpretation, perform compliance reporting, lead special projects, and develop and implement compliance medical loss ratio auditing and monitoring strategies.

• Respond to external requests for information required by the organization for its medical loss ratio regulatory filings
• Manage compliance oversight or medical loss ratio reporting and assist in responding to inquiries from state and federal regulatory agencies
• Manage ethics and compliance medical loss ratio projects or implementations
• Review and synthesize regulatory requirements and create policy and/or position statements
• Communicate state and federal requirements to internal and external clients
• Provide development guidance and assist in the identification, implementation, and maintenance of compliance policies, procedures and work instructions
• Assist in the identification, analysis, and resolution of medical loss ratio compliance issues
• Maintain and review medical loss ratio regulatory documentation necessary to maintain corporate standards
• Perform periodic compliance audits, risk assessments and conducts related to ongoing compliance monitoring activities
• Assist health plans in managing relationships with regulatory agencies and seek to resolve policy issues which may negatively impact service to members
• Serve as a company-wide resource and liaison on medical loss ratio policies, contract issues and provisions, communications, workflow, and quality improvements initiatives

• Bachelor’s degree in related legal field or equivalent experience
• Master’s or Juris Doctorate degree preferred and may be considered in lieu of experience
• 3+ years of related experience in compliance, privacy and/or regulatory affairs. Experience in project management with working knowledge of laws and/or regulations in the area of compliance, in particular HIPAA, and state regulations

Pay Range: $70,100.00 - $ 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 individual's 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