Top 29968 Complex case mgr Jobs

Corporate Ethics & Compliance Investigator
Centene —Missouri
- $107,700 - $199,300 a year
- Full-time
- Remote
- 7 years
- Management
- HIPAA
- Paid holidays
- Health insurance
Employee Labor Relations - Case Management
A P Ventures LLC —Remote
- From $90,000 a year
- Remote
- Background check
- 5 years
- Mid-level
Quick Apply
Case Manager, Reimbursement
United Biosource Corporation —Remote
- Full-time
- Remote
- 6 years
- Mid-level
- Bachelor's degree
- Wellness program
- Health savings account
12d
Coordinator, Ambulatory Case Management (REMOTE)
TEXASCONNECT INC —Remote
- Multiple hires
- Remote
- Spanish
- Microsoft Excel
- Mid-level
Executive Case Manager (Remote)
Valeris —Remote
- Remote
- Bilingual
- Background check
- 5 years
- Health savings account
- AD&D insurance
Quick Apply
Case Manager
University of California, Riverside —Riverside, CA
- $90,034.56 - $127,598.00 a year
- Full-time
- Mid-level
- Master's degree
- University
Platform Coordinator - Home Health
Pinnacle Home Care —Remote
- Full-time
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Health insurance
- Referral program
Quick Apply
Health & Benefits - Fraud Investigator (Remote)
Inspira Financial Trust, LLC —Oak Brook, IL
- $76,000 - $85,000 a year
- Remote
- Microsoft Outlook
- Mid-level
- 3 years
- Health savings account
- Paid holidays
Distribution Case Manager
BetterLife —Remote
- $55,000 - $65,000 a year
- Full-time
- Remote
- Mid-level
- Microsoft Office
- Finance
- Life insurance
Quick Apply
Case Manager / Patient Advocate (non-clinical)
Valeris —Remote
- Monday to Friday
- Remote
- Background check
- Spanish
- Pass drug screening
- Health savings account
- AD&D insurance
Quick Apply
Rehab Supervisor (Physical Therapist) - Home Health
NEOGREEN Solutions —Los Angeles, CA
- $130,000 a year
- CPR Certification
- Management
- BLS Certification
- Paid holidays
- Health insurance
Quick Apply
Registered Nurse (RN) - Case Manager - $5,000 Signing Bonus for July Starts
Adaptive Home Health —Centennial, CO
- $64.10 per point
- Weekends as needed
- RN License
- BLS Certification
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Registered Nurse (RN) - Case Manager - $5,000 Signing Bonus for July Starts
Adaptive Home Health —Lakewood, CO
- $64.10 per point
- Weekends as needed
- RN License
- BLS Certification
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Program Supervisor
Alameda Family Services —Alameda, CA
- $90,000 - $110,000 a year
- Full-time
- Background check
- LMFT
- Spanish
- Health insurance
- Dental insurance
Quick Apply
Registered Nurse (RN) - Case Manager - $5,000 Signing Bonus for July Starts
Adaptive Home Health —Aurora, CO
- $64.10 per point
- Weekends as needed
- RN License
- BLS Certification
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Registered Nurse (RN) - Case Manager - $5,000 Signing Bonus for July Starts
Adaptive Home Health —Thornton, CO
- $64.10 per point
- Weekends as needed
- RN License
- BLS Certification
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Licensed Clinical Social Worker
Deer Oaks - The Behavioral Health Solution —Moscow, ID
- Choose your own hours
- Licensed Clinical Social Worker
- Adults
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Licensed Clinical Professional Counselor (LCPC)
Deer Oaks - The Behavioral Health Solution —Moscow, ID
- Choose your own hours
- Adults
- Mid-level
- Driver's License
- Paid holidays
- Health insurance
Quick Apply
Licensed Psychologist – Functional Restoration Program (FRP)
Foothill Psychological Associates —Los Angeles, CA
- $104,000 - $108,160 a year
- Full-time
- Hybrid work
- Spanish
- Doctoral degree
- English
Quick Apply
Licensed Marriage and Family Therapist
Deer Oaks - The Behavioral Health Solution —Moscow, ID
- Choose your own hours
- LMFT
- Adults
- Mid-level
- Paid holidays
- Health insurance
Quick Apply

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Corporate Ethics & Compliance Investigator

Centene -
Missouri

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

complex case mgr jobs

Corporate Ethics & Compliance Investigator

Employee Labor Relations - Case Management

Case Manager, Reimbursement

Coordinator, Ambulatory Case Management (REMOTE)

Executive Case Manager (Remote)

Case Manager

Platform Coordinator - Home Health

Health & Benefits - Fraud Investigator (Remote)

Distribution Case Manager

Case Manager / Patient Advocate (non-clinical)

Rehab Supervisor (Physical Therapist) - Home Health

Registered Nurse (RN) - Case Manager - $5,000 Signing Bonus for July Starts

Registered Nurse (RN) - Case Manager - $5,000 Signing Bonus for July Starts

Program Supervisor

Registered Nurse (RN) - Case Manager - $5,000 Signing Bonus for July Starts

Registered Nurse (RN) - Case Manager - $5,000 Signing Bonus for July Starts

Licensed Clinical Social Worker

Licensed Clinical Professional Counselor (LCPC)

Licensed Psychologist – Functional Restoration Program (FRP)

Licensed Marriage and Family Therapist

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