Principal Compliance Investigator

🔥 0 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $107.7k - $199.3k / year

⏰ Full Time

🔴 Lead

🚔 Compliance

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Healthcare Insurance • Non-profit • Social Impact

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

• Responsible for leading and managing the most complex, sensitive, and high-impact internal investigations across the organization • Serves as a strategic advisor and subject matter expert on investigative best practices, regulatory compliance, and risk mitigation • Independently evaluates and assesses allegations to determine whether domestic laws, regulatory policies, or internal policies, procedures, and standards have been violated • Plans, scopes, and conducts complex, confidential internal investigations from inception to conclusion • Conducts, manages, and documents interviews with witnesses, as required for investigatory purposes • Identifies risks, interprets investigation results, and recommends and communicates remedial actions to mitigate future potential risks • Performs follow up to ensure remedial / disciplinary measures are implemented appropriately and timely • Plans, develops, leads, and manages multiple projects, including prioritizing and managing through execution • Maintains meticulous case files and chronologies in accordance with best practices • Communicates directly with Federal or State regulators • Supports the development and maintenance of Corporate Compliance policies and procedures and workflows

🎯 Requirements

• Bachelor's Degree Criminal Justice/Criminology, Law, Healthcare Administration/Health Policy, or related field, equivalent experience required • Juris Doctorate highly preferred • 7+ years progressive experience in conducting and managing complex investigations or auditing and risk analysis required • 7+ years experience reading, analyzing and interpreting State and Federal laws, rules and regulations required • Prosecutorial experience preferred • Previous experience as an investigator within a large corporation or Federal Agency preferred • Certified Fraud Investigator preferred

🏖️ Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules