Centene Corporation Compliance Auditor (Non Clinical) in Sunrise, Florida

ProfessionalPosition Purpose: Perform operational and compliance risk based audits for the health plan.

  • Develop schedule and perform health plan audits and specialty care company (subcontractor) audits for either federal or state managed care programs

  • Evaluate processes and performance through audits for scalability, effectiveness, efficiency, and risk mitigation

  • Provide written audit documentation regarding state and/or federal managed care programs and process audit observations

  • Review and analyze responses to audit observations and findings and facilitate corrective action plans

  • Facilitate Health Plan and specialty care company (subcontractor) compliance through corrective action process. Identify, develop and implement corrective actions and training materials to improve program performance based on audit outcomes

  • Provide education and training to internal and external entities as needed on programs, compliance, and fraud, waste and abuse

  • Serve as a resource related to the health plan and specialty care company (subcontractor) programs

Education/Experience: Bachelor's degree in, Business, Accounting, Finance, Healthcare related field or equivalent experience. 2+ years of compliance experience, preferably with State or Federal managed care programs.

Western Sky: CPC (Certified Professional Coder) required

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

TITLE: Compliance Auditor (Non Clinical)

LOCATION: Sunrise, Florida

REQNUMBER: 1120202

COMPANY: Quality Assurance

POSITION TYPE: Professional