Operations Auditor

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. Location Requirement: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.Work Schedule:This is a fully remote position with a standard Monday through Friday schedule, 8:00 AM to 5:00 PM CST.Position Purpose: Audit systems entry, performance metrics and work processes for assigned functionsAudit accuracy of new group set-ups, existing contract changes, group terminationsDesign, implement, and manage data review processes to ensure accuracy and integrity of PDM/Credentialing data reports to meet regulatory and operational requirementsExecute risk based audits evaluating controls and processes for scalability, efficiency, and risk mitigation strategiesCompile audit findings and report to management, making recommendations for modifications and improvements to operations, systems and procedures via work plans, graphs and reporting metricsEnsure defined goals are implemented and relevant supporting documents are available to measure goal performanceCoordinate auditing outcomes to identify, develop and publish corrective actions and educational material related to audit errorsExamine and evaluate information systems, recommending controls to ensure system reliability and data integrityIdentify and resolve system issues with data loadResearch state contract requirements and accrediting body standards and identify areas that present potential risk to the companyPerforms other duties as assignedComplies with all policies and standardsEducation/Experience: 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.Preferred Qualifications: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.Pay Range: $56,200.00 - $101,000.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total c...