Director, Special Investigations Unit (siu)

Centene

Remote, US
$118,400.00 - $219,000.00 py
Remote
Waste, abuse and fraud investigations
Audits and medical code editing
Federal and state medicaid guidelines
Centene is seeking a Director for its Special Investigations Unit (SIU) to oversee investigations related to fraud, waste, and abuse within managed care, ensuring compliance with federal and state regulations. The position is remote and offers a competitive salary and comprehensive benefits

Job Summary

  • Oversee a full range of waste, abuse and fraud investigations, audits and medical code editing scenarios.
  • Ensure all audits adhere to federal and state Medicaid fraud, waste and abuse guidelines.
  • Respond to all legal inquiries including subpoenas and court appearances.

Matching Summary

Match Score: 85

Centene is seeking a Director for its Special Investigations Unit (SIU) to oversee investigations related to fraud, waste, and abuse within managed care, ensuring compliance with federal and state regulations. The position is remote and offers a competitive salary and comprehensive benefits.

Salary

$118,400.00 - $219,000.00 per year

Skills & Requirements

Must-have

  • waste, abuse and fraud investigations
  • audits and medical code editing
  • federal and state Medicaid guidelines
  • operational reviews and final reviews
  • continuous auditing processes
  • legal inquiries and subpoenas

Nice-to-have

  • transforming the health of communities
  • fresh perspective on workplace flexibility
  • new technologies implementation

Key Requirements

  • Bachelor's degree or equivalent
  • 7+ years of related compliance experience
  • 7+ years of special investigation experience
  • Managed care or CMS experience

Work Rights

Not specified

Tailored Resume

Cover Letter