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Remote Clinical Review Manager: Healthcare Integrity Lead

Centene Corp.

Kansas City, MO
  • Remote job

Centene Corp. in the United States is seeking a Manager of Clinical Review for a 100% remote leadership role. You will lead a team of clinical investigators, oversee complex Fraud, Waste & Abuse cases, and collaborate with providers and stakeholders across multiple markets. The role requires a strong clinical foundation and experience in healthcare investigations. Responsibilities include auditing reviews, identifying risk patterns, and driving cost-effective improvements while ensuring #J-18808-Ljbffr Centene Corp.

Vacancy posted 1 day ago
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