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Added 2 hours ago
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Senior Graphic Designer
Centene Corporation
Jefferson City, MO
- $56,200 to $101,000 USD / year
Added 8 hours ago
CC
Contract Negotiator III
Centene Corporation
Sacramento, CA
- $70,100 to $126,200 USD / year
Added 23 hours ago
CC
Manager, Special Investigation Unit (SIU)
Centene Corporation
Tallahassee, FL
- $87,700 to $157,800 USD / year
Added 23 hours ago
Workforce Real-Time Management Analyst II
Centene Corporation
Tallahassee, FL
Added 1 day ago
CC
Lead Financial Systems Analyst
Centene Corporation
Austin, TX
- $87,700 to $157,800 USD / year
Added 1 day ago
CC
Financial Systems Analyst II
Centene Corporation
Austin, TX
- $56,200 to $101,000 USD / year
Added 1 day ago
CC
Manager, Payment Integrity
Centene Corporation
Austin, TX
- $87,700 to $157,800 USD / year
Added 1 day ago
Program Manager II
Centene Corporation
Austin, TX
Added 1 day ago
CC
Quality Improvement Specialist I
Centene Corporation
Sacramento, CA
- $23.23 to $39.61 USD / hour
Key Details: Candidate must reside in California, with a preference for candidates located in Southern California
Added 1 day ago
CC
Senior Office Services Coordinator
Centene Corporation
Clayton, MO
- $23.23 to $39.61 USD / hour
This is an onsite position Monday-Friday, candidates must reside near Clayton, MO
Added 1 day ago
CC
Marketing Driver
Centene Corporation
QUEENS, NY
- $15.87 to $27.25 USD / hour
Added 1 day ago
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Marketing Driver
Centene Corporation
QUEENS, NY
- $15.87 to $27.25 USD / hour
Added 1 day ago
CC
Senior Manager, Data Analysis
Centene Corporation
Olympia, WA
- $107,700 to $199,300 USD / year
Added 1 day ago
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Behavioral Health Medical Policy Analyst
Centene Corporation
Tallahassee, FL
- $70,100 to $126,200 USD / year
Added 1 day ago
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Supervisor, Grievance & Appeals
Centene Corporation
Tallahassee, FL
- $56,200 to $101,000 USD / year
Added 1 day ago
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Finance Analyst III - Healthcare Analytics
Centene Corporation
Tallahassee, FL
- $70,100 to $126,200 USD / year
Added 2 days ago
CC
Care Manager (Behavioral Health)
Centene Corporation
Trenton, NJ
- $56,200 to $101,000 USD / year
Candidates must reside in Essex or Morris County, or in a nearby bordering county, and the closest company office is located in Iselin, NJ
Added 2 days ago
CC
Contract Implementation Analyst
Centene Corporation
MECHANICSBURG, PA
- $23.23 to $39.61 USD / hour
Added 2 days ago
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Director, Privacy & Security Culture
Centene Corporation
Jefferson City, MO
- $134,600 to $249,000 USD / year
Added 2 days ago
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Director, Enterprise Content Strategy
Centene Corporation
Jefferson City, MO
- $107,700 to $199,300 USD / year
Added 2 days ago
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Director, Brand Strategy
Centene Corporation
Jefferson City, MO
- $107,700 to $199,300 USD / year
Added 2 days ago
Manager, Third Party Risk Management
Centene Corporation
Jefferson City, MO
Added 2 days ago
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Supervisor, Workforce Management
Centene Corporation
Jefferson City, MO
- $75,300 to $135,400 USD / year
Added 2 days ago
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Project Manager V
Centene Corporation
Madison, WI
- $107,700 to $199,300 USD / year
Added 2 days ago
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Manager, Utilization Management
Centene Corporation
Oklahoma City, OK
- $87,000 to $161,300 USD / year
Key Details: This is a remote position, but candidates must reside in Oklahoma and hold an active RN license

Centene Corporation

Manager, Payment Integrity

Austin, TX, United States

$87,700 to $157,800 USD / year · Full-time

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Job details

Pay: $87,700 to $157,800 USD / year
Job type: Full-time
Posting language: English
Posted: Oct 10, 2026

Original job description

Business Area: Accounting, Finance & Actuarial

Job Type: Full time

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/federal meetings as required by specific contracts
Prepare/present the FWA program to state/federal personnel upon request, specifically during readiness reviews, and immediately following the go live or upon state agency personnel changes
Review post-payment cases with appropriate parties to obtain refund
Prepare and distribute monthly and quarterly saving reports
Performs other duties as assigned
Complies with all policies and standards

Education/Experience:

Bachelor’s degree in Business, Healthcare, Criminal Justice, related field, or equivalent experience. 4+ years of medical claim investigation, compliance or fraud and abuse experience. Thorough knowledge of medical terminology required. Previous experience in managed care environment and as a lead or supervisor of staff, including hiring, training, assigning work and managing performance preferred.

License/Certification: Medical records or coding license 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 - 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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More about this job

Skills

Business processes
Regulatory compliance
Lead a team
Develop digital educational materials
Medical terminology
Mentor individuals

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