Hiring: Senior Compliance Investigator Company: Centene Corporation Location: Connecticut, United States Job Posted Time: 2026-09-03 11:04:15 Employment Type: Full-time / Remote Target Skills & Keywords : Root Cause Analysis About the job Experience: •4+ years of experience in investigations, auditing and risk analysis required. •1+ year of experience in reading, analyzing and interpreting State and Federal laws, rules and regulations required. Required Skills: •Leads and conducts compliance and ethics investigations across all business units and health plans, including but not limited to assessment of allegations, review of relevant documents, witness interviews, analysis of facts, root cause analysis, and preparation of investigation reports with recommended remedial or disciplinary actions. •Independently evaluates and assesses allegations to determine applicable criteria, including federal and state regulations, the Centene Code of Conduct, and internal policies, procedures, and standards that are alleged to have been violated. •Adheres to Compliance Investigation workplans and protocols and conducts investigations in compliance with established protocols and timelines. •Provides weekly case summaries and adheres to established minimum case review quotas to ensure timely progression and resolution of the investigative caseload. •Ensures all investigative findings are clearly tied to applicable company policies (e.g., Code of Conduct), federal and state regulations, and to maintain regulatory defensibility and support appropriate remediation. •Provides timely reports, both orally and in writing, to the Director of Ethics & Investigations and/or senior management regarding the status and outcomes of investigations. •Thoroughly documents, organizes, and reviews case files within centralized case management systems (e.g., Archer) in accordance with Company policy and CIU protocols. •Collaborates cross-functionally with other departments, including Legal, People Relations, SIU, Privacy, Finance, and Business Operations on investigations and the investigative process. Qualifications: •Managed care or health insurance company experience preferred. •Demonstrated experience conducting ethics and compliance investigations in a regulated healthcare environment preferred. •Certified Fraud Examiner (CFE) preferred. •Certified Compliance & Ethics Professional (CCEP) or Certified Healthcare Compliance (CHC) preferred. •A Bachelor's Degree in Related Field or Associates with 5 years of applicable experience, or a High School/GED with 6 years of applicable experience may substitute for the Bachelor's Degree, required. Compensation: •$70,100 - $126,200 / year •Flexible work environment (work from home / hybrid options) •Competitive benefits and rewards package •Managed care or health insurance company experience preferred Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!