Top 43 Investigator Jobs in South Dakota

Senior Compliance Investigator
Centene —South Dakota
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
3d
Research Psychiatric Nurse Practitioner
Circle Clinical Research —Sioux Falls, SD
- $65 - $90 an hour
- Part-time
- Nursing
- Doctoral degree
- Psychiatry
Quick Apply
Credentialed Background Investigator
CACI —Rapid City, SD
- $26.07 an hour
- Part-time
- Ability to walk for extended periods
- Writing skills
- English
- Health insurance
Mitigation Specialist - Pierre or Rapid City, SD
Federal Public Defender —Rapid City, SD
- $74,678 - $163,514 a year
- Full-time
- Microsoft Outlook
- Computer literacy
- Writing skills
- Health insurance
- Life insurance
Quick Apply
Surveillance Investigator
Frasco Inc —Sioux Falls, SD
- $20 - $26 an hour
- Part-time
- Clean driving record
- Military
- Writing skills
- Paid training
- Mileage reimbursement
Surveillance Investigator II - Experienced
Command Investigations, LLC —South Dakota
- $25 - $30 an hour
- 8 hour shift
- Microsoft Word
- Clean driving record
- Customer service
- Health insurance
- Dental insurance
Quick Apply
Surveillance Investigator I - Entry Level
Command Investigations, LLC —South Dakota
- $20 - $25 an hour
- 8 hour shift
- Microsoft Word
- Clean driving record
- Customer service
- Health insurance
- Dental insurance
Quick Apply
Surveillance Investigator - Part Time
Allied Universal® Compliance and Investigations —Rapid City, SD
- Part-time
- Microsoft Word
- Military
- High school diploma or GED
- AD&D insurance
- Paid holidays
Quick Apply
7d
Surveillance Investigator
Allied Universal® Compliance and Investigations —Sioux Falls, SD
- Weekends as needed
- Microsoft Word
- Military
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
7d
Clinical Research Coordinator - Sioux Falls, SD
IQVIA —Sioux Falls, SD
- $35 - $42 an hour
- Part-time
- Vital signs
- Clinic experience
- Office
As Needed Field Investigator- Rapid City, SD
J T Becker & Co Inc —Rapid City, SD
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
Entry Level Background Investigator (Midwest Region) - TOP SECRET CLEARANCE REQUIRED
CACI —Sioux Falls, SD
- $26.07 an hour
- Part-time
- Ability to walk for extended periods
- Writing skills
- English
- Health insurance
2d
Principal Investigator: Study Management
Clinglobal Group —Brookings, SD
- Full-time
- Management
- 5 years
- Bachelor of Science
- Disability insurance
- Health insurance
Quick Apply
Certified Professional Coder, Special Investigations Unit (Aetna SIU)
CVS Health —South Dakota
- $43,888 - $93,574 a year
- Full-time
- Remote
- Microsoft Excel
- Research
- Mid-level
- Health insurance
- Dental insurance
As Needed Field Investigator- Sturgis, SD
J T Becker & Co Inc —Sturgis, SD
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
As Needed Field Investigator- Sioux Falls, SD
J T Becker & Co Inc —Sioux Falls, SD
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
BSA Investigations Analyst II
STRIDE BANK NA —Sioux Falls, SD
- Full-time
- Research
- Mid-level
- Office
1d
Clinical Research Rater | Part Time | PRN
Circle Clinical Research —Sioux Falls, SD
- $35 - $55 an hour
- Part-time
- Nursing
- Psychiatry
- Mid-level
Quick Apply
10d
Appellate Assistant Federal Public Defender
Federal Public Defender —Sioux Falls, SD
- $76,748 - $180,078 a year
- Full-time
- Writing skills
- Mid-level
- Presentation skills
- Health insurance
- Life insurance
Quick Apply
NSF NRT Project Coordinator
South Dakota Board of Regents —Rapid City, SD
- From $19.27 an hour
- Weekends as needed
- English
- Mid-level
- Driver's License
- Paid holidays
- Retirement plan
19h

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Senior Compliance Investigator

Centene -
South Dakota

Apply Now

Job Details

Full-time
$70,100 - $126,200 a year
3 days ago

Benefits

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

Qualifications

Investigations regulatory compliance
Medical law
State healthcare regulations
Investigating compliance violations
Risk & issue management

Full Job Description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Under the general direction of the VP of Compliance Investigations this position assists with the development, implementation, and continuous monitoring of an enterprise-wide Compliance Investigations Program and leads the Company's Compliance Investigations for all Business Units, Health Plans, and Corporate functions. Leads and oversees compliance and ethics investigations, facilitates and leads meetings with business management and cross-functional stakeholders, and prepares, reviews, and analyzes internal and external reporting. Supports the Director, Ethics & Investigations in the day-to-day operations of the Compliance Investigations Unit (CIU).

Leads and conducts compliance and ethics investigations across all business units and health plans, including but not limited to assessment of allegations, review of relevant documents, witness interviews, analysis of facts, root cause analysis, and preparation of investigation reports with recommended remedial or disciplinary actions.
Independently evaluates and assesses allegations to determine applicable criteria, including federal and state regulations, the Centene Code of Conduct, and internal policies, procedures, and standards that are alleged to have been violated.
Adheres to Compliance Investigation workplans and protocols and conducts investigations in compliance with established protocols and timelines.
Provides weekly case summaries and adheres to established minimum case review quotas to ensure timely progression and resolution of the investigative caseload.
Ensures all investigative findings are clearly tied to applicable company policies (e.g., Code of Conduct), federal and state regulations, and to maintain regulatory defensibility and support appropriate remediation.
Provides timely reports, both orally and in writing, to the Director of Ethics & Investigations and/or senior management regarding the status and outcomes of investigations.
Thoroughly documents, organizes, and reviews case files within centralized case management systems (e.g., Archer) in accordance with Company policy and CIU protocols.
Collaborates cross-functionally with other departments, including Legal, People Relations, SIU, Privacy, Finance, and Business Operations on investigations and the investigative process.
Prepares and analyzes departmental metrics, including investigation KPIs, case aging, and trending data, and makes recommendations accordingly.
Prepares presentations and presents findings to departmental and business management, executive leadership, and other stakeholders as needed.
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, including tracking remediation activities through case management systems.
Assists with various projects as assigned by the Director of Ethics & Investigations or the VP of Compliance Investigations.
Performs other duties as assigned.
Complies with all policies and standards.

Education/Experience:

A Bachelor's Degree in Related Field or Associates with 5 years of applicable experience, or a High School/GED with 6 years of applicable experience may substitute for the Bachelor's Degree, required.
4+ years of experience in investigations, auditing and risk analysis required.
1+ year of experience in reading, analyzing and interpreting State and Federal laws, rules and regulations required.

Preferred Qualifications:

Managed care or health insurance company experience preferred.
Experience with compliance case management systems (e.g., Archer, Navex) preferred.
Demonstrated experience conducting ethics and compliance investigations in a regulated healthcare environment preferred.
Experience collaborating with cross-functional teams including Legal, People Relations, SIU, and Privacy preferred.

Licenses and Certifications:

Certified Fraud Examiner (CFE) preferred.
Certified Compliance & Ethics Professional (CCEP) or Certified Healthcare Compliance (CHC) preferred.

Pay Range: $70,100.00 - $126,200.00 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

investigator jobs in south dakota

Senior Compliance Investigator

Research Psychiatric Nurse Practitioner

Credentialed Background Investigator

Mitigation Specialist - Pierre or Rapid City, SD

Surveillance Investigator

Surveillance Investigator II - Experienced

Surveillance Investigator I - Entry Level

Surveillance Investigator - Part Time

Surveillance Investigator

Clinical Research Coordinator - Sioux Falls, SD

As Needed Field Investigator- Rapid City, SD

Entry Level Background Investigator (Midwest Region) - TOP SECRET CLEARANCE REQUIRED

Principal Investigator: Study Management

Certified Professional Coder, Special Investigations Unit (Aetna SIU)

As Needed Field Investigator- Sturgis, SD

As Needed Field Investigator- Sioux Falls, SD

BSA Investigations Analyst II

Clinical Research Rater | Part Time | PRN

Appellate Assistant Federal Public Defender

NSF NRT Project Coordinator

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