Operations Auditor

Centene Corporation•Remote-KS, KS

4d•$56,200 - $101,000•Remote

About The Position

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. This is a fully remote position with a standard Monday through Friday schedule, 8:00 AM to 5:00 PM CST. To be considered for this opportunity, candidates must reside in the state of Kansas. Applicants who reside in Kansas City, Missouri are also eligible for consideration.

Requirements

Bachelor’s degree in related field, or equivalent experience.
3+ years of auditing or process improvement experience, preferably in a managed care setting.
Knowledge of state contract and accreditation requirements.

Nice To Haves

Experience with LTSS, Home- and Community-Based Services, case management, managed care, HEDIS, or KDADS-related audit activities.
Prior experience auditing case files, reviewing documentation, identifying trends, and recommending process improvements.
Strong attention to detail, organizational skills, time management, and ability to work independently in a remote environment.

Responsibilities

Audit systems entry, performance metrics and work processes for assigned functions
Audit accuracy of new group set-ups, existing contract changes, group terminations
Design, implement, and manage data review processes to ensure accuracy and integrity of PDM/Credentialing data reports to meet regulatory and operational requirements
Execute risk based audits evaluating controls and processes for scalability, efficiency, and risk mitigation strategies
Compile audit findings and report to management, making recommendations for modifications and improvements to operations, systems and procedures via work plans, graphs and reporting metrics
Ensure defined goals are implemented and relevant supporting documents are available to measure goal performance
Coordinate auditing outcomes to identify, develop and publish corrective actions and educational material related to audit errors
Examine and evaluate information systems, recommending controls to ensure system reliability and data integrity
Identify and resolve system issues with data load
Research state contract requirements and accrediting body standards and identify areas that present potential risk to the company
Performs other duties as assigned
Complies with all policies and standards