Director, Special Investigations Unit (siu)

Centene

Continental United States
Base: $118,400.00 - $219,000.00 py; bonus/equity: ...
Hybrid
Oversee waste abuse and fraud investigations
Ensure adherence to federal state medicaid guidelines
Interpret audit results for executive action plans
This role involves overseeing a full range of waste, abuse, and fraud investigations to transform the health of communities for 28 million members

Job Summary

  • This role involves overseeing a full range of waste, abuse, and fraud investigations to transform the health of communities for 28 million members.
  • The position requires interpreting audit results and assisting health plan executives in developing action plans to address identified risks.
  • Centene offers competitive benefits including health insurance, 401K, stock purchase plans, and flexible remote work options across the Continental United States.

Matching Summary

This role involves overseeing a full range of waste, abuse, and fraud investigations to transform the health of communities for 28 million members.

Salary

Base: $118,400.00 - $219,000.00 per year; Bonus/Equity: Additional forms of incentives may apply; Benefits: Comprehensive package including health insurance, 401K, stock purchase plans, tuition reimbursement, and paid time off

Skills & Requirements

Must-have

  • Oversee waste abuse and fraud investigations
  • Ensure adherence to federal state Medicaid guidelines
  • Interpret audit results for executive action plans
  • Implement continuous auditing processes from design to report
  • Respond to legal inquiries subpoenas and court appearances

Nice-to-have

  • Experience with new technology implementation
  • Ability to work remotely anywhere in Continental US
  • Collaboration with managed care organizations and government employees

Key Requirements

  • Bachelor's degree in Accounting Criminal Justice Finance or related field
  • 7+ years of related compliance and special investigation experience
  • Experience in managed care or CMS environments

Work Rights

Not specified

Tailored Resume

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