Centene Corporation · 2 weeks ago
Director, Special Investigative Unit (SIU)
United States
Full-time
Remote
Director/Executive
$116K/yr - $215K/yr
7+ years expCentene Corporation is transforming the health of communities, aiming to improve the lives of 28 million members. They are seeking a Director for the Special Investigative Unit (SIU) to oversee investigations related to fraud, waste, and abuse, ensuring compliance with state and federal regulations.
Hospital & Health Care
Responsibilities
Oversee the activities of the SIU for accurate and timely operational reviews and final reviews
Interpret audit results and assist health plan executives in the development of appropriate action plans to address identified risks
Develop and implement continuous auditing processes from analytic design to final report stage
Identify and direct the implementation of new technologies
Ensure compliance with all state and federal regulations for fraud and abuse
Respond to all legal inquiries including subpoenas and court appearances
Attend federal CMS and state fraud meetings with other managed care organizations, and state and federal employees
Qualification
Required
Bachelor's degree in Accounting, Criminal Justice, Finance, Medical Professional, Economics, Operations Management or related field or equivalent
7+ years of related compliance and/or special investigation experience in managed care or CMS
Benefits
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Company
Centene Corporation
Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Beth Johnson
President and CEO, Coordinated Care
Clyde White
President & CEO (New Hampshire Healthy Families)
Recent News
Business Journals
2024-05-06
FierceHealthcare
2024-04-28
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