Senior Compliance Investigator

Centene
Missouri
Workplace: RemoteFull timeUSD 70,100 - 126,200 annuallyFunction: Legal, Risk & ComplianceSkills: ["Investigation","Risk analysis","Root cause analysis","Cross-functional collaboration","Written reporting"]

Lead and oversee compliance and ethics investigations across business units and health plans, including evaluating allegations, applying federal/state regulations and company policies, and conducting interviews and root-cause analyses. Manage investigation protocols and timelines, produce investigation reports and case summaries, and ensure findings are tied to applicable requirements. Use centralized case management systems to document work, track remediation, analyze KPIs, and collaborate with cross-functional teams such as Legal, SIU, Privacy, and People Relations.

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FursaFursa
Centene
Centene
1 day ago

Senior Compliance Investigator

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Source: Company careers pageValidated by: Fursa AI
Last checked: 9 hours agoStatus: Live
Reposted: similar role first listed 1 month ago

Job Summary

Lead and oversee compliance and ethics investigations across business units and health plans, including evaluating allegations, applying federal/state regulations and company policies, and conducting interviews and root-cause analyses. Manage investigation protocols and timelines, produce investigation reports and case summaries, and ensure findings are tied to applicable requirements. Use centralized case management systems to document work, track remediation, analyze KPIs, and collaborate with cross-functional teams such as Legal, SIU, Privacy, and People Relations.
Location: Missouri
Workplace: Remote
Employment Type: Full time
Job Function: Legal, Risk & Compliance
Seniority: Mid level

Key Responsibilities

  • •Assist with development, implementation, and continuous monitoring of an enterprise-wide Compliance Investigations Program.
  • •Lead compliance and ethics investigations, including assessment of allegations, document review, witness interviews, and preparation of investigation reports.
  • •Independently evaluate allegations against applicable criteria, including the Centene Code of Conduct and federal/state regulations and internal policies.
  • •Ensure timely progression by adhering to investigation workplans, protocols, case review quotas, and centralized documentation in case management systems.
  • •Provide weekly case summaries and timely oral/written reporting to leadership; track remediation follow-up and analyze investigation metrics/KPIs.

Pay and Benefits

Salary: USD 70,100 - 126,200 annually
Perks:Health Insurance401kPaid LeaveRemote WorkEquity

Key Requirements

  • •Bachelor’s degree in a related field (or Associate’s with 5 years applicable experience; or High School/GED with 6 years applicable experience) required.
  • •4+ years of experience in investigations, auditing, and risk analysis required.
  • •1+ year of experience reading, analyzing, and interpreting state and federal laws, rules, and regulations required.
  • •Ability to conduct investigations using documented workplans/protocols and produce investigation reports with recommended remedial or disciplinary actions.
  • •Preferred: experience with compliance case management systems (e.g., Archer, Navex).
Experience:InvestigationsAuditingRisk analysisRegulated healthcare
Skills:InvestigationRisk analysisRoot cause analysisCross-functional collaborationWritten reporting
Certifications:Certified Fraud Examiner (CFE)Certified Compliance & Ethics Professional (CCEP)Certified Healthcare Compliance (CHC)
Tech Stack:ArcherNavex

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