Centene
Healthcare
CorporateEthics&ComplianceInvestigator
Neural analysis suggests this role is
optimal for Senior candidates.
“Corporate Ethics & Compliance Investigator at Centene. Skills: leading and managing complex, sensitive, and high-impact internal investigations, serving as a strategic advisor and subject matter expert on investigative best practices, regulatory compliance, and risk mitigation. leading and managing the most complex, sensitive, and high-impact internal investigations across the organization. consults with management, in-house counsel, and/or the Director of Corporate Compliance as needed to resol”
What You'll Achieve.
Recommended corrective and disciplinary actions; remedial actions to mitigate future potential risks; ensure remedial / disciplinary measures are implemented appropriately and timely; ensures remediation activities are tracked and implemented
Industry & Context.
Independently evaluates and assesses allegations to determine whether domestic laws, regulatory policies, or internal policies, procedures, and standards have been violated; analyzing records; conducting root cause analysis; Identifies risks; interprets investigation results
What They're Looking For.
Must Have
Bachelor's Degree Criminal Justice/Criminology, Law, Healthcare Administration/Health Policy, or related field, equivalent experience required, 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
Nice to Have
Juris Doctorate highly preferred, Prosecutorial experience preferred, Previous experience as an investigator within a large corporation or Federal Agency preferred, Certified Fraud Investigator preferred
What You'll Do.
leading and managing the most complex
and high-impact internal investigations across the organization
consults with management
and/or the Director of Corporate Compliance as needed to resolve difficult
highly sensitive or complex compliance issues
independently evaluates and assesses allegations to determine whether domestic laws
and standards have been violated
confidential internal investigations from inception to conclusion
and documents interviews with witnesses
as required for investigatory purposes
reviews investigation reports prepared by junior investigators
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
maintains meticulous case files and chronologies in accordance with best practices
and reviews case files
electronic and hardcopy
relative to each investigation in accordance with Company policy and ensures remediation activities are tracked and implemented
prepares clear and concise draft investigation plans and reports
provides support and guidance to junior investigation staff as applicable
actively participates in
and/or leads meetings with various business area managers
communicates directly with Federal or State regulators
supports the development and maintenance of Corporate Compliance policies and procedures and workflows
participates in and leads special projects (e. g.
and HIPAA compliance)
provides support of and guidance to other associates
complies with all policies and standards
How You'll Work.
Team & Collaboration
Consults with management, in-house counsel, and/or the Director of Corporate Compliance; Provides support and guidance to junior investigation staff; Attends, actively participates in, and/or leads meetings with various business area managers; Provides support of and guidance to other associates
Communication Scope
Communicates directly with Federal or State regulators; Prepares clear and concise draft investigation plans and reports
Process & Methodology
Plans, develops, leads, and manages multiple projects, including prioritizing and managing through execution
Full 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:** 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. Requires exceptional judgment, discretion, and the ability to influence senior leadership decisions while ensuring adherence to federal and state regulations, internal policies, and ethical standards. * Consults with management, in-house counsel, and/or the Director of Corporate Compliance as needed to resolve difficult, highly sensitive or complex compliance issues. * 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. This includes defining investigation strategy, preserving evidence, conducting interviews, analyzing records, conducting root cause analysis, and recommended corrective and disciplinary actions. * Conducts, manages, and documents interviews with witnesses, as required for investigatory purposes. * Reviews investigation reports prepared by junior investigators. * 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
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