$116K - 215K a year
Implement and manage a quality monitoring process for investigations, maintain compliance tools, drive strategic initiatives, manage policies, and oversee training programs.
Bachelor's degree plus 7+ years of compliance or special investigation experience in managed care or CMS, with JD or prior compliance/audit experience preferred.
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: Drive high quality and compliant investigations through the implementation and management of a robust investigations quality monitoring process. This role will be responsible for: • Implementing and managing an SIU-wide quality monitoring process • Maintaining tools and resources to effectively monitor compliance with state and federal requirements • Drive strategic transformation initiatives through effective change management • Manage department policies and standard operating procedures • Oversee the training and onboarding programs Education/Experience: Bachelor's degree in Accounting, Criminal Justice, Finance, Medical Professional, Economics, Operations Management or related field or equivalent. 7+ years of related compliance and/or special investigation experience in managed care or CMS. JD or prior compliance/audit experience preferred. Pay Range: $116,100.00 - $214,700.00 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
This job posting was last updated on 9/22/2025