Manager, Payment Integrity - Platform Management

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:** Develop, implement and manage strategic fraud, waste and abuse activities by maintaining state and federal requirements and monitoring trends/schemes

+ Monitor business processes and systems to assure integrity and compliance in billing and claims payment
+ Lead teams of analysts to appropriately investigate all possible fraud, waste and abuse referrals
+ Develop customized fraud plans to meet contract and federal requirements
+ Develop educational materials to identify/validate waste activities as requested by the health plan and on an ad-hoc basis
+ Respond to RFP request and implement new policies per contractual obligation
+ Attend state/feder...

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