Case Auditor

Job not on LinkedIn

🔥 3 hours ago

🌪️ Oklahoma – Remote

🌪️ Oklahoma – Remote

💵 $20 - $34 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Conduct regular audits of care management records, documentation, and workflows • Ensure compliance with internal policies, NCQA standards, and regulatory requirements • Identify trends, discrepancies, and potential risk areas and provide recommendations to leadership • Develop and maintain audit tools, scorecards, and tracking systems • Collaborate with care management leadership on audit findings and corrective action plans • Support development and updating of policies, procedures, and training materials • Monitor process changes for sustained compliance and improved quality outcomes • Provide feedback and guidance on documentation requirements, best practices, and quality standards • Participate in staff training related to compliance and care management • Prepare audit reports and present findings to management • Track performance metrics, compliance trends, and improvement initiatives • Participate in internal and external audits as needed • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

• Must reside in Oklahoma • High School diploma or GED • 2–4 years of related experience • May require vocational or technical education in addition to prior work experience • Experience with auditing, case management, NCQA, HEDIS, and healthcare regulatory requirements • Computer savvy • Excellent communication, customer service, organizational, and time-management skills • Ability to work Monday through Friday, 8:00 AM to 5:00 PM

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation, subject to eligibility