Senior Compliance Auditor (6383)

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time.

As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

This is a hybrid position. The team meets in the Columbus, OH office on Wednesdays, but is able to work from home on Monday, Tuesday, Thursday, and Friday.

Position Purpose : Responsible for the development and implementation of the health plan’s compliance audit work plan. Completes Prospective and retrospective audits on a monthly, quarterly and annual basis.

• Identify regulatory oversight deficiencies, process gaps and communicate audit observations, analyzes findings to provide recommendations on process improvements to the Chief Compliance Officer.
• Utilize compliance knowledge to analyze audit findings and in answering disputed findings.
• Develop and implement compliance improvement and corrective action plans based on risk analysis, audit findings, and health plan performance.
• Develop audit processes based on contract requirements defined by Centers for Medicare and Medicaid Services (CMS), State, Federal, Medicaid and / or NCQA guidelines.
• Maintain documentation on health plan performance and provide reports to departments as required for audits and risk assessments.
• Train internal audit participants / business owners on audit processes.

Education / Experience : Bachelor’s degree in Health Care, Law, Accounting, Psychology or related field. Master’s degree preferred.

3+ years of healthcare compliance and auditing / monitoring experience.

License / Certification : Compliance or auditing certifications preferredPay Range : $67,400.00 - $121,300.00 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.

Total compensation may also include additional forms of incentives.