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.
*Applicants for the job have the flexibility to work remote from home anywhere in the United States.
Position Purpose: Oversee the operation of the Contract Implementation Analyst and Claims Liaison teams.
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Oversee the claims operation function, including contracting and configuration
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Monitor staff performance to identify any process or quality gaps and develop/implement business solutions to correct issues
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Provide management with necessary data to expedite resolution of claims issues and support in policy decisions related to claims operations
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Serve as the subject matter expert in resolution of claims and configuration issues
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Manage the health plan’s workflow to assure timely, accurate submission and implementation of contracts
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Act as health plan interface on software product upgrades/implementations that affect contract implementation
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Promote change through establishment and sharing of best practices
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Interface with all organizational levels to mobilize commitment and ensure accurate configuration, contract implementation, and claims operations
Education/Experience: Bachelor’s degree in related field or equivalent experience. 5+ years of provider relations/services, provider contracting and/or claims administration experience in a managed care environment. Experience with Medicare and Medicaid claims and contracting preferred.
Pay Range: $86,000.00 - $154,700.00 per year
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
