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Manager, External Audit Compliance

Role overview

Qualifications

  • Bachelor's Degree in Business Administration, Healthcare Administration, Compliance, Law or related field; or equivalent experience required
  • Master's Degree preferred
  • Juris Doctor (JD) preferred
  • 4+ years Compliance experience, preferably in a healthcare environment; or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position required
  • 2+ years Medicaid, Medicare or Commercial Managed Care experience required

Responsibilities

  • Manage and oversee the coordination of regulatory audits, examinations, and oversight activities for a regional portfolio of Medicaid health plans
  • Lead a team of audit coordinators supporting regulatory audits and examinations
  • Oversee audit readiness, coordination, documentation management, and stakeholder engagement activities
  • Partner with health plan leadership, Operations, Compliance, and business subject matter experts throughout the audit lifecycle
  • Monitor audit timelines, deliverables, risks, and escalation items
  • Present audit status updates, risks, trends, and outcomes to leadership audiences
  • Drive adherence to established audit management processes and continuous improvement initiatives
  • Mentor and develop team members while ensuring workload balancing and effective resource allocation

Key facts

Other skills

  • Leadership
  • Mentorship
  • Teamwork
  • Communication

About the company

Centene Corporation logo

Centene Corporation

Health Insurance (Payers)

Centene Corporation provides high-quality healthcare services to members in all 50 states. Since its founding in 1984, Centene has worked to transform the health of communities, one person at a time. Centene is the largest Medicaid managed care organization in the country and provides a portfolio of services to government sponsored healthcare programs. Centene believes that healthcare is best delivered locally. Our local health plans offer a range of health insurance solutions with a focus on providing accessible care to uninsured and under-insured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). Centene also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services. Centene’s hiring practices reflect the composition of the members and communities we serve, allowing us to deliver quality, culturally sensitive healthcare to millions of members. Centene employees help change the world of healthcare and transform our communities. To learn more about career opportunities with Centene, visit: https://jobs.centene.com/

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

Position Purpose: Manage and oversee the coordination of regulatory audits, examinations, and oversight activities for a regional portfolio of Medicaid health plans across the West Region. Provide leadership and direction to team members responsible for day-to-day audit execution while ensuring consistent application of departmental processes and standards.

Key Details:  Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States. However, the selected candidate must be available to work Pacific Time business hours and will be required to travel as needed for business purposes.

  • Lead a team of audit coordinators supporting regulatory audits and examinations.
  • Oversee audit readiness, coordination, documentation management, and stakeholder engagement activities across assigned markets.
  • Partner with health plan leadership, Operations, Compliance, and business subject matter experts throughout the audit lifecycle.
  • Monitor audit timelines, deliverables, risks, and escalation items.
  • Present audit status updates, risks, trends, and outcomes to leadership audiences.
  • Drive adherence to established audit management processes and continuous improvement initiatives.
  • Support development of audit strategies, lessons learned, and knowledge-sharing practices across markets.
  • Mentor and develop team members while ensuring workload balancing and effective resource allocation.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Education/Experience:

  • Bachelor's Degree Business Administration, Healthcare Administration, Compliance, Law or related field; or equivalent experience required
  • Master's Degree preferred
  • Juris Doctor (JD) preferred
  • 4+ years Compliance experience, preferably in a healthcare environment; or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position required
  • 2+ years Medicaid, Medicare or Commercial Managed Care experience required
  • Previous experience demonstrating effective interaction with federal and state regulatory agencies in a managed care or insurance environment preferred

Pay Range: $87,700.00 - $157,800.00 per year

At Centene, we connect people to the care they need to live healthier lives β€” and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
 

Centene 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 compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
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