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Director, SIU

2 months ago

New York, New York, United States Centene Full time
Senior Investigator - Waste, Abuse and Fraud

As a Senior Investigator at Centene, you will play a critical role in ensuring the integrity of our healthcare services and protecting our members from waste, abuse, and fraud.

Key Responsibilities:

  • Lead a team of investigators in conducting thorough and timely reviews of audit results, identifying areas of risk and developing action plans to address them.
  • Develop and implement continuous auditing processes, from design to final report stage, to ensure compliance with federal and state regulations.
  • Collaborate with health plan executives to identify and mitigate risks, and ensure that all audits adhere to relevant guidelines.
  • Stay up-to-date with the latest technologies and implement new solutions to improve efficiency and effectiveness.
  • Ensure compliance with all state and federal regulations, and respond to legal inquiries and subpoenas as needed.
  • Represent Centene at federal and state meetings, working with other managed care organizations and government agencies to share best practices and stay informed.

What You'll Gain:

  • A comprehensive benefits package, including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off, and a flexible approach to work that allows you to balance your work and personal life.
  • The opportunity to work with a talented team of professionals who share your passion for delivering high-quality healthcare services.
  • A commitment to diversity, equity, and inclusion, and a company that values making a positive impact on the communities we serve.