Director, Regulatory Operations

Centene Corporation

. Direct and oversee regulatory compliance operations for assigned products/services .

Posted 10/5/2026full-timeRemote • United StatesLead💰 $107,700 - $199,300 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in regulatory compliance operations, including the ability to develop and implement compliant policies and procedures in accordance with CMS and contract requirements. Strong knowledge of federal and state regulations, along with experience in managing regulatory complaints and providing guidance on compliance issues.

Highest-signal resume keywords

Regulatory Compliance OperationsCMS RegulationsPolicy DevelopmentHealth Care ComplianceComplaint Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Regulatory CompliancePolicy DevelopmentProcess ImplementationRegulatory AnalysisContract Language KnowledgeGrievance SupportRegulatory DocumentationFederal Program RegulationsState RegulationsCompliance Measures

Soft Skills

GuidanceCommunicationProblem-SolvingCollaborationResearch

Industry Keywords

Health CareCMSDOIOIGHIPAARegulatory OperationsCompliance StrategyCorporate ComplianceRegulatory Impact AnalysisMarketplace Products

About the role

Key responsibilities & impact

Direct and oversee regulatory compliance operations for assigned products/services
Oversee, administer, and implement the Ambetter Regulatory Operations program
Manage regulatory complaints, complaint escalations, and grievance support
Create processes and strategies supporting corporate compliance
Coordinate and document Centene responses to CMS/regulator requests for information or response
Provide guidance to departments on compliance and regulatory issues
Ensure implementation of new compliance requirements related to regulatory and contract language
Identify, evaluate, and analyze the impact of CMS and Marketplace regulatory issues
Advise management on regulatory impacts
Partner with departments to communicate and meet state and federal regulatory requirements
Maintain and track laws, regulations, contract documentation, amendments, and compliance measures
Ensure Marketplace products and services are tested for regulatory compliance
Develop and update policies, procedures, and processes according to CMS and contract requirements

Requirements

What you’ll need

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Bachelor's degree in Business Administration, Health Care Administration, related field or equivalent experience
7+ years of regulatory, compliance, operations, or related experience
Experience preferably in a health care environment
Advanced degree preferred
Ability to research and apply CMS, DOI, OIG, and HIPPA regulations
Knowledge of federal program regulations and applicable state regulations
Knowledge of regulatory and contract language
Ability to develop compliant policies, procedures, and processes

Benefits

Comp & perks

Competitive pay
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation