Jobs › Centene

Manager, Special Investigation Unit (SIU)

Centene · FL · Remote available · $87,700–$157,800 a year · Full time

Posted Sep 2, 2026 · We last checked this listing on Oct 6, 2026

Apply at Centene

Likely interview questions for this role

Written from this job description, not a generic list. Each one notes what the interviewer is really checking.

About your past

Walk me through a fraud, waste or abuse case you worked from referral to recovery.

What they are checking: Whether they understand the full life of an SIU case, including evidence, provider contact and getting money back.

Tell me about a time you hired, trained or coached an investigator. What did you focus on?

What they are checking: Whether they can build investigators who are thorough and fair, since the posting prefers supervisory experience.

What would you do

An investigator on your team wants to close a case quickly because the dollar amount is small. How do you respond?

What they are checking: Whether they weigh patterns and contract duties, not just dollar size, when deciding what to pursue.

A provider pushes back hard on a post-payment overpayment finding and threatens to leave the network. What do you do?

What they are checking: Whether they stand on documented evidence while handling the provider relationship professionally.

How would you design education for a health plan about a waste trend you are seeing?

What they are checking: Whether they can turn investigation findings into prevention, which the posting lists as part of the job.

About the work

How do you tell the difference between billing error, waste and intentional fraud when you first look at a referral?

What they are checking: Whether they can separate honest mistakes from schemes, which decides how a provider is treated.

What data mining approaches have you used to spot unusual billing patterns in claims?

What they are checking: Whether they can find leads proactively in data rather than waiting only for tips and referrals.

How do state and federal requirements shape how you run an SIU, such as referrals to the state or reporting timelines?

What they are checking: Whether they know an SIU runs under contract and regulatory obligations, not just internal priorities.

How do you build monthly and quarterly savings reports that leadership can trust?

What they are checking: Whether they separate identified, recovered and avoided dollars honestly instead of inflating results.

What medical coding issues do you see most often in fraud and abuse work, like upcoding or unbundling?

What they are checking: Whether their coding knowledge is deep enough to read a claim and see what does not fit.

Practice this interview out loud.

Offer builds a real interview for this exact role at Centene from your resume and this job description, asks the questions one at a time, and tells you what landed. The first one is free.

Practice this out loud

The full job description

As published by Centene.

Position Purpose: Develop, implement and manage strategic fraud, waste and abuse activities by maintaining state and federal requirements and monitoring trends and schemes. • Monitor business processes and systems to assure integrity and compliance in billing and claims payment • Lead a team appropriately investigate all possible fraud, waste and abuse referrals • Develop educational materials to address/identify waste activities as requested by the health plan and on an ad-hoc basis • Attend state/federal meetings as required by specific contracts • Review post-payment cases with appropriate parties to obtain refund • Prepare and distribute monthly and quarterly saving reports • Participate in Appeals Committee, work groups and interdepartmental meetings Education/Experience: • 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. License/Certification: • Medical records or coding license preferred. Pay Range: $87,700.00 - $157,800.00 per year At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday. 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 , including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. 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

Apply at Centene