Senior Manager, Claims Configuration Operations

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 

Position Purpose: Oversee operations, and business strategy utilizing cross-functional departments to meet strategic objectives.

• Perform data analysis from a variety of data sources to evolve the metrics used to measure effectiveness and return on investment of all current and new product activity.
• Collaborate with staff to identify internal and external customers and their expectations, initiate process changes to increase quality, decrease costs and improve staff, provider and member satisfaction.
• Oversee all work flows of the departments while maintaining production and quality standards.
• Ensure compliance with all related laws, regulations and executive orders.
• Review and analyze reports, records and directives, and confer with staff to obtain data required for planning work function activities.
• Assist in the establishment of the departmental strategies and objectives.
• Explore new approaches to work processes by utilizing quality improvement techniques to eliminate waste and re-work.
• Performs other duties as assigned.
• Complies with all policies and standards.

Knowledge/:
Education/Experience: Bachelor's degree in Management, Business Administration, related field or equivalent experience. 6+ years of operations experience. Experience with managed care, insurance, Medicare or Medicaid preferred. Experience with leading claims configuration teams as well as skills with SQL and Power BI strongly preferred.

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