Corporate Ethics & Compliance Investigator

Centene Corporation•Remote-MO, MO

10d•$107,700 - $199,300•Hybrid

About The Position

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 accordance with best practices. Thoroughly documents, organizes, 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. Attends, 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., auditing, training, and HIPAA compliance). Provides support of and guidance to other associates. Performs other duties as assigned. Complies with all policies and standards.

Requirements

Bachelor's Degree in 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.

Nice To Haves

Juris Doctorate
Prosecutorial experience
Previous experience as an investigator within a large corporation or Federal Agency
Certified Fraud Investigator

Responsibilities

Lead and manage complex, sensitive, and high-impact internal investigations.
Serve as a strategic advisor and subject matter expert on investigative best practices, regulatory compliance, and risk mitigation.
Evaluate and assess allegations to determine violations of laws, regulations, or policies.
Plan, scope, and conduct confidential internal investigations from inception to conclusion.
Define investigation strategy, preserve evidence, conduct interviews, analyze records, and perform root cause analysis.
Recommend corrective and disciplinary actions.
Conduct, manage, and document interviews with witnesses.
Review investigation reports prepared by junior investigators.
Identify risks, interpret investigation results, and recommend remedial actions.
Perform follow-up to ensure remedial/disciplinary measures are implemented.
Plan, develop, lead, and manage multiple projects, including prioritization and execution.
Maintain meticulous case files and chronologies.
Document, organize, and review case files, ensuring remediation activities are tracked and implemented.
Prepare clear and concise draft investigation plans and reports.
Provide support and guidance to junior investigation staff.
Attend, participate in, and/or lead meetings with business area managers.
Communicate directly with Federal or State regulators.
Support the development and maintenance of Corporate Compliance policies and procedures and workflows.
Participate in and lead special projects (e.g., auditing, training, and HIPAA compliance).
Provide support and guidance to other associates.
Perform other duties as assigned.
Comply with all policies and standards.