Manager, Special Investigation Unit (SIU)

Job description

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. Position Purpose: Develop, implement and manage strategic fraud, waste and abuse activities for our Arizona and Nevada markets, as well as, Dental and Vision, by maintaining state and federal requirements and monitoring trends and schemes. Education/Experience: Bachelor’s degree in Business, Healthcare, Criminal Justice, related field, or equivalent experience. 4+ years of combined medical claim investigation, financial impact analysis, business analysis, compliance or fraud and abuse experience. Thorough knowledge of medical terminology. Previous experience in managed care environment and as a lead or supervisor of staff, including hiring, training, assigning work and managing performance preferred. Knowledge of Microsoft Excel, medical coding, claims processing, and data mining preferred. License/Certification: Medical records or coding license preferred. Pay Range: $87,700.00 - $157,800.00 per y...