Centene Corporation Operations Auditor II in Little Rock, Arkansas

Description:

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

  • 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 and identify areas that present potential risk to the company

Qualifications:

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 MS Office 2010 with heavy emphasis on MS Access and Excel, SQL, Graphing and Metrics. Knowledge of state contract and accreditation requirements.

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.

Job: Health Insurance Operations

Organization: G&A-Billing & Collections

Location: Arkansas-Little Rock

Requisition ID: 1068125