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Director, Compliance and Health Equity

Company: Delaware First Health
Location: Newark
Posted on: November 23, 2022

Job Description:

You could be the one who changes everything for our 26 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: Oversee the health plan's compliance program through risk management and process improvement activities and responsible for implementing the health plan's Cultural Competency Program. --- Conduct compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with local, state and regulatory requirements.
--- Represent the key leadership position for compliance at the health plan, oversee communication, coordinate of policy development and ensure accurate and timely communication to all departments.
--- Investigate instances of suspected fraud within the health plan and report to appropriate management and regulatory entities.
--- Assist management with enforcement and discipline in appropriate instances of non ---compliance.
--- Regularly inform health plan's Board of Directors of the status of and activities pertaining to compliance.
--- Promotes an environment of cultural competence throughout the health plan through identification and implementation of culturally-inclusive best practices and innovations, such as the development of provider trainings to improve cultural awareness and competency within the provider network.
--- Partners with community, regional and statewide organizations and stakeholders to identify opportunities to collaborate to improve delivery of culturally competent programs and services.
--- Assesses cultural diversity of the provider network to identify resources and gaps, including needs analysis for non-traditional providers (traditional healers, religious and spiritual resources, natural support systems, etc.) and develops recommendations for credentialing and network development activities. Monitors and evaluates provider practices through KPIs within health equity dashboards to assess and improve the cultural competence of delivered services by addressing care gaps and aligning interventions to resolve.
--- Responsible for implementation of population specific activities (such as training, awareness through the media, and partnering with various external equity stakeholders), including cultural treatment teams and other cultural community support system activities. Identify trends in specific populations and recommend interventions. Identifies population health disparities and creates outreach, community activities, and innovative programming to engage in services.
--- Creates and implements a comprehensive, outcomes-based Cultural Competency Plan that is aligned with the state standards and national and regional priorities/initiatives. The plan also incorporates data-driven assessments of culturally competent performance, and defines a strategy for the continual provision, monitoring and improvement of culturally competent performance.
--- Manages outreach budget for Cultural Competency programs and sponsorships. Education/Experience: Bachelor's degree in related field or equivalent experience. 5+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits; 2+ years experience in the development of compliance and fraud programs; 2 years experience with overseeing implementation of contract requirements. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff. Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development. 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.

Keywords: Delaware First Health, Newark , Director, Compliance and Health Equity, Executive , Newark, Delaware

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