Manager, Special Investigation Unit – SIU

Centene Corporation

Centene SIU Manager overseeing healthcare fraud, waste and abuse investigations and compliance. Leading teams, analyzing claims, and reporting savings for Florida health plans.

Posted 9/2/2026full-timeRemote • Florida • 🇺🇸 United StatesMid-LevelSenior💰 $87,700 - $157,800 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in fraud, waste, and abuse management, with a strong focus on compliance, medical terminology, and claims processing. Proven ability to lead teams, conduct investigations, and develop educational materials to mitigate waste activities.

Highest-signal resume keywords

Fraud InvestigationMedical Claim AnalysisCompliance ManagementTeam LeadershipData Mining

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical TerminologyClaims ProcessingFinancial Impact AnalysisBusiness AnalysisFraud and Abuse ExperienceMedical CodingBilling IntegrityTrend MonitoringPost-Payment ReviewEducational Material Development

Soft Skills

Team ManagementPerformance ManagementCommunication

Tools & Technologies

Microsoft Excel

Certifications & Qualifications

Medical Records LicenseCoding License

Industry Keywords

Managed CareFraud PreventionWaste ManagementAbuse PreventionState and Federal Compliance

About the role

Key responsibilities & impact

Develop, implement and manage strategic fraud, waste and abuse activities
Maintain state and federal requirements and monitor trends and schemes
Monitor business processes and systems to assure integrity and compliance in billing and claims payment
Lead a team to appropriately investigate all possible fraud, waste and abuse referrals
Develop educational materials to address and identify waste activities
Attend state and federal meetings as required by specific contracts
Review post-payment cases with appropriate parties to obtain refunds
Prepare and distribute monthly and quarterly savings reports
Participate in Appeals Committee, work groups and interdepartmental meetings

Requirements

What you’ll need

Bachelor’s degree in Business, Healthcare, Criminal Justice, related field, or equivalent experience
4+ years of combined medical claim investigation, financial impact analysis, business analysis, compliance or fraud and abuse experience required
Thorough knowledge of medical terminology required
Previous experience in managed care environment and as a lead or supervisor of staff, including hiring, training, assigning work and managing performance preferred
Knowledge of Microsoft Excel, medical coding, claims processing, and data mining preferred
Medical records or coding license preferred

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation