Job Overview
Location
Remote-MO
Job Type
Full-time
Category
Operations
Date Posted
April 8, 2026
Full Job Description
đź“‹ Description
- • As Director, Payment Integrity at Centene Corporation, you will lead efforts to prevent waste, abuse, and fraud in healthcare payments, directly impacting the accuracy and integrity of claims processing for 28 million members.
- • Day to day, you will oversee prepay editing and retrospective audits, interpret audit findings, develop corrective action plans, and present insights to senior leadership to drive payment accuracy and compliance.
- • You will join a diversified, national healthcare organization committed to transforming community health, where your work supports regulatory adherence and operational excellence across state and federal programs.
- • In this role, you will develop and implement payment integrity programs, lead training initiatives for providers and staff, mentor Prepay Compliance Managers, and shape strategic initiatives that improve payment accuracy and reduce financial risk.
🎯 Requirements
- • Bachelor’s degree in Accounting, Finance, Nursing, Operations Management, Healthcare-related field, or equivalent experience
- • 7+ years of experience in finance, accounting, operations, or auditing
- • Experience in claims operations preferred
- • Strong knowledge of state and federal healthcare regulations and compliance requirements
- • Proven ability to develop and implement audit programs, policies, and procedures
- • Experience leading teams and delivering educational training to providers and employees
🏖️ Benefits
- • Competitive pay within the range of $118,400.00 - $219,000.00 per year
- • Comprehensive benefits package including health insurance, 401K, and stock purchase plans
- • Tuition reimbursement and paid time off plus holidays
- • Flexible work arrangements with remote, hybrid, field, or office options
- • Commitment to diversity, equity, and inclusion as an equal opportunity employer
Skills & Technologies
About Centene Corporation
Centene Corporation is a publicly traded managed-care enterprise that arranges health-benefit programs for government-sponsored and privately insured individuals. Operating across all 50 U.S. states and internationally, the company focuses on under-insured and uninsured populations through Medicaid, Medicare, and Marketplace offerings. Its services include behavioral health, pharmacy benefits, vision, dental, telehealth, and in-house clinical programs. Centene partners with physicians, hospitals, and community organizations to coordinate cost-effective care, emphasizing data analytics and value-based reimbursement models. Headquartered in St. Louis, Missouri, it serves more than 25 million members, positioning itself as a leading intermediary between payers and healthcare providers.
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