Top 48 Centene Jobs in Remote

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
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
Manager, Credentialing
Fidelis Care —New York, NY
- $70,100 - $126,200 a year
- Full-time
- Remote
- Management
- Computer literacy
- Writing skills
- Paid holidays
- Health insurance
4d
Community Relations Specialist
Centene Medicare —Atlanta, GA
- $56,200 - $101,000 a year
- Full-time
- Remote
- Marketing
- Mid-level
- Driver's License
- Paid holidays
- Health insurance
5d
Senior Clinical Review Nurse - Prior Authorization
Fidelis Care —New York, NY
- $30.58 - $55.09 an hour
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
Quality Improvement Coordinator II
Coordinated Care —Washington, DC
- $33.71 - $60.67 an hour
- Full-time
- Remote
- Nursing
- LVN
- RN License
- Paid holidays
- Health insurance
9d
Community Relations Representative II
Carolina Complete Health —Charlotte, NC
- $56,200 - $101,000 a year
- Full-time
- Remote
- Bilingual
- Marketing
- Mid-level
- Paid holidays
- Health insurance
4d
Senior Director, Gold Card Program
Centene —New York, NY
- $134,600 - $249,000 a year
- Full-time
- Remote
- 7 years
- Management
- Bachelor's degree
- Paid holidays
- Health insurance
Program Manager III
Fidelis Care —New York, NY
- $87,700 - $157,800 a year
- Full-time
- Remote
- 5 years
- Master's degree
- Bachelor's degree
- Paid holidays
- Health insurance
3d
Process Improvement Specialist (Clinical)
Meridian Michigan —Taylor, MI
- $70,100 - $126,200 a year
- Full-time
- Remote
- RN License
- Licensed Clinical Social Worker
- Driver's License
- Paid holidays
- Health insurance
3d
Manager, Payment Integrity-COB/TPL /Subrogation
Centene —New York, NY
- $87,700 - $157,800 a year
- Full-time
- Remote
- Management
- Mid-level
- Supervising experience
- Paid holidays
- Health insurance
2d
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
Manager, Actuarial Services
Centene —New York, NY
- $134,600 - $249,000 a year
- Full-time
- Remote
- 5 years
- Research
- SQL
- Paid holidays
- Health insurance
Manager, SIU Intelligence & Innovation
Centene —New York, NY
- $87,700 - $157,800 a year
- Full-time
- Remote
- Computer science
- Computer Science
- Master's degree
- Paid holidays
- Health insurance
9d
Associate Actuary, Strategic Analytics
Centene —New York, NY
- $87,700 - $157,800 a year
- Full-time
- Remote
- Mid-level
- SQL
- Math
- 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
Lead SIU Investigator
Centene —Washington, DC
- $70,100 - $126,200 a year
- Full-time
- Remote
- Master's degree
- High school diploma or GED
- Mentoring
- Paid holidays
- Health insurance
Manager, Sales I
Centene Medicare —New York, NY
- $70,100 - $126,200 a year
- Full-time
- Remote
- Spanish
- Marketing
- English
- Paid holidays
- Health insurance
9d
Senior Director, Medical Economics
Centene —Washington, DC
- $148,000 - $274,200 a year
- Full-time
- Remote
- Finance
- Master's degree
- 8 years
- Paid holidays
- Health insurance
8d
Sr. Actuarial Analyst - Risk Adjustment
Centene —New York, NY
- $70,100 - $126,200 a year
- Full-time
- Remote
- Mid-level
- SQL
- Math
- Paid holidays
- Health insurance

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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

centene jobs in remote

Corporate Ethics & Compliance Investigator

Manager, Sales Investigations

Manager, Credentialing

Community Relations Specialist

Senior Clinical Review Nurse - Prior Authorization

Quality Improvement Coordinator II

Community Relations Representative II

Senior Director, Gold Card Program

Program Manager III

Process Improvement Specialist (Clinical)

Manager, Payment Integrity-COB/TPL /Subrogation

SIU Investigator

Manager, Actuarial Services

Manager, SIU Intelligence & Innovation

Associate Actuary, Strategic Analytics

Associate Actuary

Lead SIU Investigator

Manager, Sales I

Senior Director, Medical Economics

Sr. Actuarial Analyst - Risk Adjustment

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