Remote Audit Lead - Compliance Risk Adjustment

Centene Corporation; Kansas City (MO); Remote; USD 88,000 - 158,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work arrangements

Job summary

Centene Corporation is seeking a Risk Adjustment Audit Manager to oversee external audits and lead delivery of audit deliverables. The role focuses on ensuring accuracy, regulatory alignment, and timely communication with auditors across the risk adjustment function.

You will collaborate with internal teams, manage corrective actions, and present performance reports to stakeholders to drive continuous improvements in risk adjustment processes and compliance.

Qualifications

• Bachelor's degree in audit, compliance, legal or related field.
• 5+ years audit, risk adjustment and/or compliance experience.
• Experience in risk adjustment oversight and/or coding planning preferred.
• Demonstrated understanding of risk adjustment regulatory landscape preferred.
• Risk Adjustment regulatory audit experience preferred.
• Medicare experience preferred.

Responsibilities

• Serves as the point of contact for external audits, and correspondence with auditors related to audit acknowledgement, deliverables timelines and other inquiries.
• Manages external audit deliverables submission responsibilities and respond to inquiries from state and federal regulatory agencies timely.
• Quality review all external audit deliverables for completeness and accuracy prior to submission to external auditors.
• Communicate with both internal and external audit partners to clarify deliverables, audit requirements and deadlines.
• Serves as a subject matter expert on external audit processes, policies, and quality improvement initiatives.
• Socializes identified risks with internal partners including the Compliance Corrections team by timely entering Corrective Action Intake.
• Supports the Corrective Action Plan development and review prior to submission to the external auditors.
• Maintains detailed audit documentation including meeting minutes, action items, identified issues, and risk management plans.
• Prepares and presents reports to stakeholders on risk adjustment audit performance and progress.
• Supports strategy development to enhance risk adjustment accuracy and operational efficiency.
• Provides operational and analytical support to the Risk Adjustment department.
• Researches and recommends best practices for continuous improvement in risk adjustment.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

Audit & Compliance

Risk Adjustment

Regulatory Knowledge

Stakeholder Communication

Education

Bachelor's Degree in Audit, Compliance, Legal, or related field

Tools

AHIMA Credential

AAPC Credential

Job description

Centene Corporation is seeking a Risk Adjustment Audit Manager to oversee external audits and lead delivery of audit deliverables. The role focuses on ensuring accuracy, regulatory alignment, and timely communication with auditors across the risk adjustment function.

You will collaborate with internal teams, manage corrective actions, and present performance reports to stakeholders to drive continuous improvements in risk adjustment processes and compliance.