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CentenePosted 3 weeks ago

Operations Auditor

$56,200–$101,000 year

RemoteKansas City, Missouri, United States or Kansas, United States

Full TimeBachelors DegreeEnterprise

Job Summary

Audit systems entry, performance metrics, and work processes for assigned functions while ensuring accuracy of new group set-ups, contract changes, and terminations. Design, implement, and manage data review processes to maintain the integrity of PDM/Credentialing reports against regulatory and operational requirements. Execute risk-based audits evaluating controls for scalability and efficiency, then compile findings into work plans and reporting metrics to drive corrective actions and educational materials. Recommend system controls and resolve data load issues to ensure reliability, while researching state contract requirements and accrediting standards to mitigate potential risks. Fully remote position with a standard Monday through Friday schedule, 8:00 AM to 5:00 PM CST.

Required Qualifications

  • Bachelor's degree in related field, or equivalent experience
  • 3+ years of auditing or process improvement experience
  • Knowledge of state contract and accreditation requirements
  • Must reside in the state of Kansas
  • Applicants who reside in Kansas City, Missouri are also eligible for consideration

Desired Qualifications

  • Experience with LTSS, Home- and Community-Based Services, case management, managed care, HEDIS, or KDADS-related audit activities
  • Prior experience auditing case files, reviewing documentation, identifying trends, and recommending process improvements
  • Strong attention to detail
  • Organizational skills
  • Time management
  • Ability to work independently in a remote environment

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