Manager, Sales Investigations
Core
Leads day-to-day operations for a team of Sales Investigators responsible for investigating allegations of sales agent, agency, broker, and related sales-practice misconduct in the healthcare sector.
Role type
Manager, Sales Investigations
Builds
Investigative case outcomes and team operational efficiency for Centene's managed care and health plan operations
Domain
Healthcare / Managed Care / Regulatory Compliance
Deliverable
client delivery
Required skills
Team leadership and coaching, risk-based case assignment, quality review of investigative work, cross-functional stakeholder coordination, regulatory policy application, operational metrics tracking, audit support, corrective action implementation
Preferred skills
Direct people leadership experience, managed care or health plan industry experience, audit response support, Medicare sales compliance knowledge, professional certifications (CFE, AHFI, CIA, CHC/HCCA, CCP)
Technologies
Investigative protocols, approved templates, CMS-aligned guidance, internal policy systems
Responsibilities
Manage, coach, and develop investigators; assign and rebalance caseloads based on risk and complexity; oversee day-to-day investigative execution; conduct formal quality reviews of investigative plans and reports; serve as escalation point for complex matters; ensure correct application of Medicare/Medicaid sales conduct requirements; partner with Legal/Compliance/HR for remediation; track and report operational metrics; reinforce documentation practices; support audit and regulatory inquiries; implement continuous improvement of workflows
Seniority
Manager, hands-on IC with team leadership