Centene Corporation

Senior Director, Sales Investigations

Centene Corporation

full-time

Posted on:

Location Type: Remote

Location: Remote • Florida, Illinois, Montana, Texas • 🇺🇸 United States

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Salary

💰 $145,100 - $268,800 per year

Job Level

Senior

About the role

  • Serves as a strategic leader overseeing all 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 all investigative activities align with federal and state regulations, internal policies, and ethical standards, safeguarding the integrity of the organization's sales operations
  • Develop and execute the enterprise-wide strategy for sales investigations, ensuring timely, accurate, and consistent resolution of cases
  • Lead, mentor, and develop 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; oversee root cause analyses and corrective action planning
  • Ensure investigative practices comply 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 contracts and effective delivery of services supporting the Sales Investigations team
  • Develop preventative strategies, including controls, monitoring, and training, to reduce recurrence of sales-related issues
  • Serve as a trusted advisor to senior leadership on ethical sales practices and reputational risk
  • Performs other duties as assigned

Requirements

  • Bachelor’s degree compliance, legal studies, related field or equivalent experience required; master’s degree or Juris Doctor (JD) preferred
  • 7+ years progressive experience in investigations, compliance, sales oversight, or regulatory affairs within 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 complex, sensitive investigations with discretion and integrity required
  • Exceptional analytical, communication, and problem-solving skills required
  • Demonstrated ability to influence senior executives and collaborate across functions required.
Benefits
  • competitive pay
  • health insurance
  • 401K and stock purchase plans
  • tuition reimbursement
  • paid time off plus holidays
  • flexible approach to work with remote, hybrid, field or office work schedules

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
investigationscompliancesales oversightregulatory affairsanalytical skillsproblem-solving skillsrisk managementroot cause analysiscorrective action planningpreventative strategies
Soft skills
leadershipmentoringcommunicationcollaborationdiscretionintegrityinfluencingrelationship buildingteam developmentstrategic thinking
Certifications
Bachelor's degreeMaster's degreeJuris Doctor (JD)
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