Operations Auditor II

Louisiana Healthcare Connections; Baton Rouge (LA); Remote; USD 55,000 - 99,000; Full time

Job summary

A leading healthcare company is looking for an Operations Auditor II who will audit performance metrics and ensure data integrity in Louisiana. This role requires a Bachelor's degree and 3+ years of auditing experience. The position offers flexibility in work arrangements and a competitive salary including comprehensive benefits.

Benefits

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off

Flexible work schedules

Qualifications

• 3+ years of auditing experience preferably in a managed care setting.
• Knowledge of state contract and accreditation requirements.

Responsibilities

• Audit accuracy of new group set-ups and existing contract changes.
• Compile audit findings and report to management for modifications.
• Ensure defined goals are implemented to measure performance.

Skills

Auditing

Process Improvement

Data Analysis

Education

Bachelor’s degree in related field

Job description

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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 Audit systems entry, performance metrics and work processes for assigned functions

• Audit accuracy of new group set-ups, existing contract changes, group termination
• Design, implement, and manage data review processes to ensure accuracy and integrity of PDM/Credentialing data reports to meet regulatory and operational requirements
• Execute risk based audits evaluating controls and processes for scalability, efficiency, and risk mitigation strategies
• Compile audit findings and report to management, making recommendations for modifications and improvements to operations, systems and procedures via work plans, graphs and reporting metrics
• Ensure defined goals are implemented and relevant supporting documents are available to measure goal performance
• Coordinate auditing outcomes to identify, develop and publish corrective actions and educational material related to audit errors
• Examine and evaluate information systems, recommending controls to ensure system reliability and data integrity
• Identify and resolve system issues with data load
• Research state contract requirements and accrediting body standards and identify areas that present potential risk to the company
• Performs other duties as assigned
• Complies with all policies and standards
  
  

Education/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.

This position is remote within the state of Louisiana. In person meeting attendance at the Baton Rouge office required.

Pay Range $55,100.00 - $99,000.00 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 an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

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

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Accounting/Auditing and Finance

• Industries

  Hospitals and Health Care and Insurance

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