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 diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

**REMOTE POSITION – MUST BE LOCATED IN CALIFORNIA **

Position Purpose: The Audit Analyst is responsible for the quality review of functionally specific processes within operations services (claims, customer contact and membership) to ensure quality service goals and standards are met and/or identify areas where improvement can be achieved. Evaluates and interprets report data for management review. Provides feedback regarding associate performance and makes recommendations to improve quality, workflow processes, policies and procedures.

• Conducts quality review of performance within specific units for consistency with policies, procedures and any applicable regulatory guidelines.
• Records and reports review findings as required by the functional area.
• Systematically collects and provides data in order to develop reports based on the quality monitoring results.
• Provides coaching, advice and guidance as needed.
• Delivers performance feedback to associates as outlined in unit’s policies and procedures.
• Proactively identifies adverse performance trends and patterns. Provides input and recommendations for additional training or policy and procedure changes that may be required to enhance service and productivity.
• Researches and reviews documentation and ensures compliance.
• Assists in monitoring audit reports, auditing database and analyzing/compiling trend reports every week and/or month.
• Maintains a comprehensive working knowledge of policies, procedures, and benefits across all product lines.
• Participates in specialized training within the department based on performance feedback/trend reports.

Education/Experience:

• High school diploma.
• Acquired in-depth technical knowledge of functional area (claims, customer contact, or membership), typically evidenced by three years experience.
• Intermediate to Advanced Excel, Adobe, PowerPoint and Word strongly preferred.
• Knowledge/exposure or experience with regulatory regulations and auditing principals and Utilization Management function strongly preferred.

Pay Range: $18.66 - $31.73 per hour

Centene offers a comprehensive benefits package including: competitive pay, 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-related factors permitted by law.  Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, 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