Manager, Sales Investigations

Centene
Florida, Georgia, New York, Missouri, North Carolina, Texas, Illinois
Workplace: RemoteFull timeUSD 87,700 - 157,800 annuallyFunction: SalesExperience: 5+ yearsEducation: bachelorsSkills: ["Leadership","Coaching","Quality assurance","Process improvement","Stakeholder management"]

Lead a team of Sales Investigators and Senior Sales Investigators to investigate sales misconduct, ensure timely, defensible case work, and align investigations with CMS requirements and internal policies. Manage risk-based caseloads, coach staff, review quality, escalate complex matters, and partner with Compliance, Legal, HR, and Sales to drive remediation and process improvements.

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Centene
Centene
3 months ago

Manager, Sales Investigations

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Source: Company careers pageValidated by: Fursa AI
Last checked: 28 days agoStatus: Live

Job Summary

Lead a team of Sales Investigators and Senior Sales Investigators to investigate sales misconduct, ensure timely, defensible case work, and align investigations with CMS requirements and internal policies. Manage risk-based caseloads, coach staff, review quality, escalate complex matters, and partner with Compliance, Legal, HR, and Sales to drive remediation and process improvements.
Location: Florida, Georgia, New York, Missouri, North Carolina, Texas, Illinois
Workplace: Remote
Employment Type: Full time
Job Function: Sales
Seniority: Manager level

Key Responsibilities

  • •Lead day-to-day operations for a team of Sales Investigators and Senior Sales Investigators, ensuring risk-based case assignment, investigative quality, timeliness, and adherence to standards.
  • •Assign and rebalance caseloads based on risk, complexity, and regulatory time sensitivity; monitor workflow for timely completion and prioritize high-risk matters.
  • •Oversee intake-to-closure progress and adherence to approved templates, procedures, and documentation standards.
  • •Conduct formal quality reviews of plans, evidence, interview records, findings, and reports; coach for defensibility and accuracy.
  • •Act as primary escalation point for complex matters and coordinate with Legal, Compliance, HR, and Sales Operations to remediate and escalate as needed.

Pay and Benefits

Salary: USD 87,700 - 157,800 annually
Equity and Bonus:Equity
Perks:Health Insurance401kEquity

Key Requirements

  • •Bachelor's Degree in Criminal Justice, Law, Compliance, Healthcare Administration, or related field required or Associates with 6 years of applicable experience, or a High School/GED with 7 years of applicable experience may substitute for the Bachelors Degree
  • •5+ years of progressive experience in compliance, investigations, SIU, FWA, audit, or related functions in managed care, healthcare, or another similarly regulated environment required
  • •1+ year of experience in leading or managing others required
  • •Demonstrated experience reviewing investigative work product for quality, evidentiary sufficiency, and defensibility required
  • •Demonstrated experience coordinating cross-functional case activity and remediation with business stakeholders required
Experience:5+ yearsHealthcareManaged careRegulated environment
Education:Bachelor's
Skills:LeadershipCoachingQuality assuranceProcess improvementStakeholder management
Certifications:CFEAHFICIACHC/HCCACCP

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn