Clinical Investigator Behavioral Health at Centene

This mid-level role is designed for licensed behavioral health professionals (LCSW, LMFT, LPC, etc.) who have transitioned into the compliance or investigative space. You need a Master’s degree and at least two years of experience specifically identifying fraud, waste, and abuse (FWA) within medical billing and coding. The position is fully remote across several states and offers a wide salary range up to $101k, depending on experience. It provides a unique opportunity to use clinical expertise in a legal and investigative context, working alongside a Special Investigations Unit to protect healthcare integrity through forensic medical record reviews. **You might be a good fit if you...** * Hold an active independent clinical license (LMHC, LCSW, LMFT, LPC, etc.). * Have a strong background in behavioral health coding, billing patterns, and CMS guidelines. * Enjoy "detective work," such as analyzing provider billing trends and performing retrospective audits. * Can communicate complex clinical and audit findings for use in judicial hearings or provider negotiations.