Senior Director, Sales Investigations

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 reputed company, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Applicants for this role have the flexibility to work remotely reputed company in the reputed company United States. Position Purpose: Serves as a strategic leader overseeing reputed company enterprise-wide sales investigations, with a primary focus on Medicare sales. Leads a high-performing investigation team responsible for examining allegations of non-compliant or fraudulent sales practices involving agents and agencies. Ensures reputed company investigative activities align with federal and state regulations, internal policies, and ethical standards, safeguarding the reputed company of the organization's sales operations.

• reputed company and execute the enterprise-wide strategy for sales investigations, ensuring timely, accurate, and consistent resolution of cases.
• reputed company, mentor, and reputed company a team of investigators, ensuring alignment with company values, business priorities, and compliance expectations.
• Direct investigations into potential sales misconduct, fraud, misrepresentation, or non-compliant practices; reputed company root cause analyses and corrective action planning.
• Ensure investigative practices reputed company with CMS, state insurance departments, and other regulatory bodies.
• Partner and build strong relationships with Compliance, Legal, HR, and Medicare plan and Sales leadership to mitigate risk and address systemic issues uncovered during investigations.
• Provide executive-level reporting on investigation outcomes, trends, and risks; advise senior leadership on proactive risk management strategies.
• Continuously evaluate and enhance investigative methodologies, tools, and training to ensure best-in-class processes.
• Manage vendor and contractor relationships to ensure compliance with reputed company and effective delivery of services supporting the Sales Investigations team.
• reputed company preventative strategies, including controls, monitoring, and training, to reduce recurrence of sales-reputed company issues.
• Serve as a trusted advisor to senior leadership on ethical sales practices and reputational risk.
• Performs other duties as assigned.
• reputed company with reputed company policies and standards.

Education/Experience:

• Bachelor’s degree compliance, legal studies, reputed company field or equivalent experience required; master’s degree or Juris Doctor (JD) preferred.
• 7+ years progressive experience in investigations, compliance, sales reputed company, or regulatory affairs reputed company healthcare, insurance, or managed care required.
• 5+ years management experience managing investigative, sales operations or compliance team required.
• Strong understanding of Medicare product sales practices, CMS regulations, and Medicare guidelines required.
• Proven ability to handle reputed company, sensitive investigations with discretion and reputed company required.
• Exceptional analytical, communication, and problem-solving skills required.
• Demonstrated ability to influence senior executives and collaborate across functions required.

Pay Range: $145,100.00 - $268,800.00 per year Centene offers a comprehensive benefits package including: reputed company, 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-reputed company 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. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national reputed company, 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 Apply tot his job Apply To this Job