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Centene Management1 day ago

Senior Compliance Investigator

$70,100–$126,200 year

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

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

Job Summary

Senior Compliance Investigator leads and oversees compliance and ethics investigations across the Centene Compliance Investigations Unit (CIU), develops and monitors an enterprise-wide Investigations Program, and conducts investigations across business units and health plans. Responsibilities include evaluating allegations, witness interviews, document review, root cause analysis, and preparing investigation reports with recommended remedial or disciplinary actions; ensures investigations align with the Code of Conduct and regulatory requirements; provides timely reporting to Director/leadership; documents case files in centralized systems; collaborates with Legal, People Relations, SIU, Privacy, Finance, and Business Operations; analyzes departmental metrics and presents findings; supports remediation and governance efforts. Preferred qualifications include experience in managed care or health insurance, familiarity with Archer/Navex systems, and professional certifications such as CFE, CCEP, or CHC. Education/experience required: bachelor's degree or equivalent substitutions with 4+ years in investigations, auditing, risk analysis, and regulatory interpretation.

Required Qualifications

  • Bachelor's Degree in Related Field or Associate with 5 years of applicable experience, or High School/GED with 6 years of applicable experience may substitute for the Bachelor's Degree
  • 4+ years of experience in investigations, auditing and risk analysis
  • 1+ year of experience in reading, analyzing and interpreting State and Federal laws, rules and regulations
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$70k – $126k / yr

Senior Compliance Investigator · Centene Management

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