Operations Auditor II

Centene Corp.; Orlando (FL); Remote; USD 55,000 - 99,000; Full time

Job summary

Centene Corp. is seeking an Auditor to enhance health service quality through systematic audits and process improvements. This role entails auditing contract setups, designing data review processes, and ensuring compliance with regulatory standards. Candidates should possess a Bachelor's degree and relevant auditing experience, preferring those with BCBA or BCABA certifications.

Benefits

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work options

Qualifications

• 3+ years of auditing or process improvement experience, preferably in a managed care setting.
• Knowledge of state contract and accreditation requirements.
• ABA experience highly preferred.

Responsibilities

• Audit accuracy of new group set-ups and contract changes.
• Design, implement, and manage data review processes.
• Compile audit findings and make recommendations.

Skills

Auditing

Data integrity

Risk mitigation

Process improvement

Education

Bachelor’s degree in related field

BCBA or BCABA certifications

Job description

Time left to apply: End Date: June 17, 2025 (1 day left to apply)

Job requisition id: 1567307

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.

Remote-FL

**Candidates must reside in Florida**

Position Purpose: Audit systems entry, performance metrics, and work processes for assigned functions. Supports ABA (Applied Behavioral Analysis).

• Audit accuracy of new group set-ups, existing contract changes, group terminations
• 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 to identify areas that present potential risk to the company
• Performs other duties as assigned
• Complies with all policies and standards
• 25% travel

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. BCBA or BCABA certifications, preferred. ABA experience, highly preferred.

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, 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.

Welcome

Thanks for your interest in Centene and its subsidiary companies. We’re glad you’ve decided to apply and take the next step to find your purpose. If you need an accommodation, please email [e-mail].

About Us

Centene is committed to helping people live healthier lives. We provide access to high-quality healthcare, innovative programs, and a wide range of health solutions that help families and individuals get well, stay well, and be well.