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Centene Management1 day ago

Manager, Sales Investigations

$87,700–$157,800 year

Remote · New York, United States or Texas, United States

Type
Full Time
Level
Mid Level
Education
Bachelors Degree
Company size
Enterprise

Job Summary

Leads day-to-day operations for the Compliance Investigations Unit (CIU), supervising a team of Sales Investigators and Senior Sales Investigators. Responsible for risk-based case assignment, investigative quality, timeliness, and standard adherence; ensures clear, complete, defensible investigative reports aligned with internal policies, CMS requirements, and audit/regulatory expectations. Partners with Compliance leadership, Legal, Sales, HR, and other stakeholders to address issues, implement corrective actions, and escalate systemic or high-risk concerns. Manages CIU staff, oversees investigations into misconduct related to sales agents/agencies/brokers, prepares summary reports, analyzes trends, collaborates with cross-functional teams, develops training materials, and maintains policies/procedures. Ensures timely response to federal/state requirements and supports remediation activities. Remote-friendly with paid attention to flexible work arrangements including remote, hybrid, field or office schedules.

Required Qualifications

  • Bachelor's Degree in Criminal Justice, Law, Compliance, Healthcare Administration, or related field OR Associates with 6 years of applicable experience OR High School/GED with 7 years of applicable experience; 5+ years progressive experience in compliance/investigations/SIU/audit in managed care or similarly regulated environment; 1+ year of people leadership; demonstrated experience in reviewing investigative work product for quality and evidentiary sufficiency; experience coordinating cross-functional case activity and remediation with business stakeholders; professional certifications such as CFE, AHFI, CIA, CHC/HCCA, CCP or similar preferred.
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$88k – $158k / yr

Manager, Sales Investigations · Centene Management

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