Manager, SIU Intelligence & Innovation

Centene
New York, Missouri, North Carolina, Florida
Workplace: RemoteFull timeUSD 87,700 - 157,800 annuallyFunction: Data Analytics & Business IntelligenceExperience: 5+ yearsEducation: bachelorsSkills: ["Leadership","Mentoring","Strategic planning","Cross-functional collaboration","Communication"]

Lead the strategic direction and optimization of SIU analytics capabilities to detect, prevent, and investigate fraud, waste, and abuse. Drive proactive anti-fraud detection programs using internal/external data and advanced analytic tools, including predictive monitoring and dashboards. Manage and mentor analytics personnel, modernize analytics resources (e.g., PostShield/AI Shield/Pharmacy Shield), oversee vendor performance, and collaborate with enterprise stakeholders to translate complex datasets into actionable intelligence and measurable value.

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Centene
Centene
1 day ago

Manager, SIU Intelligence & Innovation

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Job Summary

Lead the strategic direction and optimization of SIU analytics capabilities to detect, prevent, and investigate fraud, waste, and abuse. Drive proactive anti-fraud detection programs using internal/external data and advanced analytic tools, including predictive monitoring and dashboards. Manage and mentor analytics personnel, modernize analytics resources (e.g., PostShield/AI Shield/Pharmacy Shield), oversee vendor performance, and collaborate with enterprise stakeholders to translate complex datasets into actionable intelligence and measurable value.
Location: New York, Missouri, North Carolina, Florida
Workplace: Remote
Employment Type: Full time
Job Function: Data Analytics & Business Intelligence
Seniority: Manager level

Key Responsibilities

  • •Lead SIU analytics strategy to support detection, prevention, and investigation of fraud, waste, and abuse.
  • •Manage, mentor, and develop analytics team members, including hiring, performance management, goal setting, and resource allocation.
  • •Optimize analytics resources and proactively develop analytic methodologies, dashboards, reporting solutions, and predictive monitoring capabilities.
  • •Evaluate emerging fraud schemes and analytical opportunities, transforming large healthcare datasets into actionable intelligence for investigations and fraud prevention.
  • •Oversee vendor relationships and represent SIU in data governance and analytics/innovation forums; communicate findings and recommendations to senior leadership.

Pay and Benefits

Salary: USD 87,700 - 157,800 annually
Perks:Health Insurance401kEquityPaid LeaveHolidaysRemote Work

Key Requirements

  • •Bachelor’s degree in a relevant field (Data Analytics, Data Science, Business Analytics, Business/Healthcare Administration, Information Systems, Statistics, Computer Science, Criminal Justice) or equivalent experience.
  • •5+ years in healthcare analytics, fraud detection, SIU operations, program integrity, payment integrity, healthcare investigations, or related analytical functions.
  • •2+ years conducting healthcare fraud investigations and understanding fraud, waste, and abuse trends and schemes.
  • •Experience leading, mentoring, coordinating, or managing analytical resources, projects, or teams.
  • •Experience building advanced analytics, predictive monitoring/modeling, reporting/data visualization, and fraud detection methodologies using large healthcare datasets.
Experience:5+ yearsHealthcareFraud detectionProgram integritySIU operationsPayment integrityHealthcare investigations
Education:Bachelor's
Skills:LeadershipMentoringStrategic planningCross-functional collaborationCommunication
Certifications:CFEAHFICHCPMPSASCPC
Tech Stack:Predictive monitoringPredictive modelingArtificial intelligenceMachine learningReportingDashboardsData visualizationFraud detection methodologiesHCFS PostShieldAI ShieldPharmacy ShieldPostShield

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