Ethics & Investigations Officer

Centene Corporation; Town of Texas (WI); Remote; USD 250,000 - 625,000; Full time

Job summary

Centene Corporation seeks an Ethics & Investigations Officer to manage compliance and ethics within the organization. The role includes leading investigations into compliance issues and fostering a culture of integrity across various departments while providing strategic oversight and partnership with executive leadership.

Benefits

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Qualifications

• 15+ years of experience in compliance, ethics, or investigations.
• 7+ years in implementing business initiatives related to risk and controls.
• Experience with compliance solutions like HIPAA, NAIC, CMS.

Responsibilities

• Lead enterprise-wide ethics investigation strategy.
• Provide oversight for internal investigations and ensure compliance.
• Integrate technology to enhance ethics and compliance processes.

Skills

Compliance

Ethics

Investigations

Risk Mitigation

Fraud Detection

Education

Bachelor’s degree in Law, Business Administration, or Healthcare Administration

Master’s Degree or similar certification (e.g., CPA, CISA)

Job description

Join to apply for the Ethics & Investigations Officer role at Centene Corporation.

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.

Applicants for this role will have the flexibility to work remotely anywhere in the Continental United States.

Position Purpose

Responsible for leading and managing the company's compliance, ethics, and investigative functions and the company's enterprise-wide ethics investigations strategy. Ensures the organization's adherence to legal, regulatory, and ethical standards while fostering a culture of integrity and accountability. Provides strategic oversight of ethics investigations related to fraud, waste, abuse, and conflicts of interest, ensuring prompt and effective resolution of compliance concerns. Drives a culture of integrity, transparency, and risk mitigation through a robust code of conduct.

• Leads the development and execution of enterprise-wide ethics investigation strategy, ensuring regulatory compliance across all business units and markets.
• Provides oversight of internal investigations into allegations of fraud, waste, abuse, and conflicts of interest. Establishes and maintains investigative protocols, ensuring consistent and fair processes. Ensures proper documentation and reporting of investigations in accordance with legal and regulatory guidelines. Coordinates with external regulators, law enforcement, and other stakeholders when necessary.
• Partners with executive leadership to align ethics and investigation initiatives with corporate goals and strategy.
• Advises the Board of Directors and executive teams on ethics and Fraud, Waste and Abuse trends, risk exposure, and regulatory developments.
• Utilizes data-driven insights and risk analytics to enhance ethics monitoring, investigative processes, and decision-making.
• Drives efficiency within compliance operations, with a focus on process optimization, risk mitigation, and internal controls.
• Leads a strategically focused team to support growth, efficiency, and positive outcomes in alignment with Centene’s core values.
• Integrates technology and automation strategies to enhance ethics and compliance effectiveness and streamline investigative processes.
• Champions a culture of ethics and compliance across all levels of the organization.
• Performs other duties as assigned.
• Ensures compliance with all policies and standards.

Education/Experience

• Bachelor’s degree in Law, Business Administration, Healthcare Administration or related field required; Master’s Degree CPA, CISA, MHA, MBA, MIS, Juris Doctor (JD) or related field preferred.
• 15+ years of progressive experience in compliance, ethics, investigations, or related field required.
• 7+ years implementing business initiatives in process, risk, and control measures required.
• 7+ years of experience with compliance-focused solutions (HIPAA, NAIC, CMS, SOX, etc.) required.
• 7+ years of experience in fraud detection and prevention, regulatory compliance, and corporate ethics preferred.

Healthcare Industry Experience

Preferred.

Licenses/Certifications

• Certified Compliance & Ethics Professional (CCEP), Certified Fraud Examiner (CFE), or similar certification preferred.

Pay range $250,000 - $625,000 per year.

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 individual skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that values diversity and inclusion. 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 protected characteristics.

Additional Details

• Seniority level: Not Applicable
• Employment type: Full-time
• Job function: Other, Information Technology, and Management
• Industries: Hospitals and Health Care, Insurance