Centene is seeking a Manager for Payment Integrity Governance to oversee fraud, waste, and abuse activities within healthcare billing and claims processing. The ideal candidate will possess extensive experience in medical claim investigation and compliance, along with strong leadership skills to manage a team of analysts
Job Summary
The role involves developing and implementing strategic fraud, waste, and abuse activities to maintain state and federal requirements.
Candidates will lead teams of analysts to investigate referrals and prepare monthly saving reports for stakeholders.
Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K, and flexible work schedules.
Matching Summary
Match Score: 85
Centene is seeking a Manager for Payment Integrity Governance to oversee fraud, waste, and abuse activities within healthcare billing and claims processing. The ideal candidate will possess extensive experience in medical claim investigation and compliance, along with strong leadership skills to manage a team of analysts.
Salary
Base: $87,700.00 - $157,800.00 per year; Bonus/Equity: Additional incentives may apply; Benefits: Health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off
Skills & Requirements
Must-have
Medical claim investigation experience
Thorough knowledge of medical terminology
State and federal compliance monitoring
Nice-to-have
Managed care environment experience
Data mining and Excel proficiency
Team leadership and hiring skills
Key Requirements
Bachelor's degree in Business, Healthcare, or Criminal Justice
4+ years of medical claim investigation or compliance experience
Previous experience as a lead or supervisor preferred