Director, Special Investigations Prepay Unit

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 medicaid guidelines
Develop continuous auditing processes
The role involves overseeing a full range of waste, abuse, and fraud investigations for 28 million members

Job Summary

  • The role involves overseeing a full range of waste, abuse, and fraud investigations for 28 million members.
  • Candidates will develop and implement continuous auditing processes from analytic design to final report stage.
  • Centene offers competitive pay, health insurance, 401K, and flexible remote work options anywhere in the Continental United States.

Matching Summary

The role involves overseeing a full range of waste, abuse, and fraud investigations for 28 million members.

Salary

Base: $118,400.00 - $219,000.00 per year; Bonus/Equity: Additional incentives may be included; Benefits: Health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off

Skills & Requirements

Must-have

  • Oversee waste, abuse, and fraud investigations
  • Ensure adherence to federal Medicaid guidelines
  • Develop continuous auditing processes

Nice-to-have

  • Experience with new technology implementation
  • Ability to respond to legal inquiries
  • Collaboration with state and federal employees

Key Requirements

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

Work Rights

Not specified

Tailored Resume

Cover Letter