Top 577 Health Net Jobs

Corporate Ethics & Compliance Investigator
Centene —New York, NY
- $107,700 - $199,300 a year
- Full-time
- Remote
- 7 years
- Management
- HIPAA
- Paid holidays
- Health insurance
Utilization Review Clinician - Behavioral Health
Centene —Washington, DC
- $27.02 - $48.55 an hour
- Weekends as needed
- Remote
- LMFT
- Nursing
- Addiction Medicine
- Paid holidays
- Health insurance
3d
Inpatient Utilization Review Clinician, Behavioral Health
Centene —Louisiana
- $27.02 - $48.55 an hour
- Full-time
- Remote
- LMFT
- Nursing
- Addiction Medicine
- Paid holidays
- Health insurance
9d
SIU Investigator
Centene —New York, NY
- $56,200 - $101,000 a year
- Full-time
- Remote
- 5 years
- Fair chance
- Senior level
- Paid holidays
- Health insurance
Senior Director, Clinical Data Science
Centene —Washington, DC
- $185,700 - $352,500 a year
- Full-time
- Remote
- Computer Science
- Master's degree
- SQL
- Paid holidays
- Health insurance
Senior Compliance Investigator
Centene —New York, NY
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
Psychologist Reviewer
Centene —Kentucky
- $87,700 - $157,800 a year
- Full-time
- Remote
- Addiction Medicine
- Mid-level
- Outpatient experience
- Paid holidays
- Health insurance
8d
Supervisory Medical Director, National Physical Health Appeals Outpatient UM
Centene —New York, NY
- $236,500 - $449,300 a year
- Full-time
- Remote
- Medicine
- 5 years
- Fair chance
- Paid holidays
- Health insurance
Remote Medical Director, Appeals
Centene —Washington, DC
- $236,500 - $449,300 a year
- Weekends as needed
- Remote
- Medicine
- Fair chance
- Senior level
- Paid holidays
- Health insurance
SIU Investigator
Centene —California
- $56,200 - $101,000 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Fair chance
- Paid holidays
- Health insurance
SIU Investigator
Centene —Ohio
- $56,200 - $101,000 a year
- Full-time
- Remote
- Mid-level
- Fair chance
- Associate's degree
- Paid holidays
- Health insurance
Associate Actuary - Medicaid
Centene —New York, NY
- $87,700 - $157,800 a year
- Full-time
- Remote
- Research
- Mid-level
- Analysis skills
- Paid holidays
- Health insurance
Manager, Actuarial Services
Centene —New York, NY
- $134,600 - $249,000 a year
- Full-time
- Remote
- 5 years
- Research
- SQL
- Paid holidays
- Health insurance
6d
Senior Adversarial Emulation - Red Team Operator
Centene —New York, NY
- $87,000 - $161,300 a year
- Full-time
- Remote
- Computer science
- Azure
- Computer Science
- Paid holidays
- Health insurance
Manager, Sales Investigations
Centene —New York, NY
- $87,700 - $157,800 a year
- Full-time
- Remote
- High school diploma or GED
- Fair chance
- 1 year
- Paid holidays
- Health insurance
Senior Actuarial Analyst
Centene —New York, NY
- $70,100 - $126,200 a year
- Full-time
- Remote
- Mid-level
- SQL
- Math
- Paid holidays
- Health insurance
7d
Quality Trainer I
Centene —Florida
- $56,200 - $101,000 a year
- Full-time
- Remote
- Research
- Mid-level
- Bachelor's degree
- Paid holidays
- Health insurance
6d
Plan President & CEO - Health Net of California
Centene —Woodland Hills, CA
- $390,000 - $740,000 a year
- Full-time
- 5 years
- Master's degree
- Bachelor's degree
- Paid holidays
- Health insurance
6d
Actuary
Centene —New York, NY
- $107,700 - $199,300 a year
- Full-time
- Remote
- Microsoft Excel
- 5 years
- SQL
- Paid holidays
- Health insurance
Associate Actuary
Centene —New York, NY
- $87,700 - $157,800 a year
- Full-time
- Remote
- Research
- Mid-level
- SQL
- Paid holidays
- Health insurance
6d

I want to receive the latest job alert for Health Net

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Corporate Ethics & Compliance Investigator

Centene -
New York, NY

Apply Now

Job Details

Full-time
$107,700 - $199,300 a year

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Investigations regulatory compliance
State healthcare regulations

Full Job Description

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: Responsible for leading and managing the most complex, sensitive, and high-impact internal investigations across the organization. Serves as a strategic advisor and subject matter expert on investigative best practices, regulatory compliance, and risk mitigation. Requires exceptional judgment, discretion, and the ability to influence senior leadership decisions while ensuring adherence to federal and state regulations, internal policies, and ethical standards.

Consults with management, in-house counsel, and/or the Director of Corporate Compliance as needed to resolve difficult, highly sensitive or complex compliance issues.
Independently evaluates and assesses allegations to determine whether domestic laws, regulatory policies, or internal policies, procedures, and standards have been violated.
Plans, scopes, and conducts complex, confidential internal investigations from inception to conclusion. This includes defining investigation strategy, preserving evidence, conducting interviews, analyzing records, conducting root cause analysis, and recommended corrective and disciplinary actions.
Conducts, manages, and documents interviews with witnesses, as required for investigatory purposes.
Reviews investigation reports prepared by junior investigators.
Identifies risks, interprets investigation results, and recommends and communicates remedial actions to mitigate future potential risks.
Performs follow up to ensure remedial / disciplinary measures are implemented appropriately and timely.
Plans, develops, leads, and manages multiple projects, including prioritizing and managing through execution.
Maintains meticulous case files and chronologies in accordance with best practices.
Thoroughly documents, organizes, and reviews case files, electronic and hardcopy, relative to each investigation in accordance with Company policy and ensures remediation activities are tracked and implemented.
Prepares clear and concise draft investigation plans and reports.
Provides support and guidance to junior investigation staff as applicable.
Attends, actively participates in, and/or leads meetings with various business area managers.
Communicates directly with Federal or State regulators.
Supports the development and maintenance of Corporate Compliance policies and procedures and workflows.
Participates in and leads special projects (e.g., auditing, training, and HIPAA compliance).
Provides support of and guidance to other associates.
Performs other duties as assigned.
Complies with all policies and standards.

Education/Experience: Bachelor's Degree Criminal Justice/Criminology, Law, Healthcare Administration/Health Policy, or related field, equivalent experience required. Juris Doctorate highly preferred. 7+ years progressive experience in conducting and managing complex investigations or auditing and risk analysis required. 7+ years experience reading, analyzing and interpreting State and Federal laws, rules and regulations required. Prosecutorial experience preferred. Previous experience as an investigator within a large corporation or Federal Agency preferred.

Licenses/Certifications:
Certified Fraud Investigator preferred

Pay Range: $107,700.00 - $199,300.00 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

Apply Now

Refine Your Search

Health Net jobs

Corporate Ethics & Compliance Investigator

Utilization Review Clinician - Behavioral Health

Inpatient Utilization Review Clinician, Behavioral Health

SIU Investigator

Senior Director, Clinical Data Science

Senior Compliance Investigator

Psychologist Reviewer

Supervisory Medical Director, National Physical Health Appeals Outpatient UM

Remote Medical Director, Appeals

SIU Investigator

SIU Investigator

Associate Actuary - Medicaid

Manager, Actuarial Services

Senior Adversarial Emulation - Red Team Operator

Manager, Sales Investigations

Senior Actuarial Analyst

Quality Trainer I

Plan President & CEO - Health Net of California

Actuary

Associate Actuary

I want to receive the latest job alert for Health Net

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected