Senior Manager, Payment Integrity - Data Mining Programs

Centene
Missouri, Georgia, North Carolina, Texas, Illinois, Florida
Workplace: RemoteFull timeUSD 107,700 - 199,300 annuallyFunction: Solutions Engineering & Sales EngineeringExperience: 6+ yearsEducation: bachelorsSkills: ["Collaboration","Analysis","Communication","Process improvement","Stakeholder management"]

Oversee and monitor internal and external cost recovery and cost containment initiatives, translating targeted metrics into forecasted recovery and avoidance goals. Manage vendor initiatives, partner with health plans to identify and contain costs, develop budgets and projected savings targets, and streamline processes to reduce costs. Present reporting and trends to senior management and support health plans in understanding payment integrity rules, regulations, and workflows while monitoring performance across departments.

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Centene
Centene
3 days ago

Senior Manager, Payment Integrity - Data Mining Programs

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Last checked: 4 hours agoStatus: Live

Job Summary

Oversee and monitor internal and external cost recovery and cost containment initiatives, translating targeted metrics into forecasted recovery and avoidance goals. Manage vendor initiatives, partner with health plans to identify and contain costs, develop budgets and projected savings targets, and streamline processes to reduce costs. Present reporting and trends to senior management and support health plans in understanding payment integrity rules, regulations, and workflows while monitoring performance across departments.
Location: Missouri, Georgia, North Carolina, Texas, Illinois, Florida
Workplace: Remote
Employment Type: Full time
Job Function: Solutions Engineering & Sales Engineering
Seniority: Manager level

Key Responsibilities

  • •Oversee and monitor internal and external cost recovery and cost containment initiatives based on targeted metrics and forecasted goals.
  • •Manage internal and external vendors’ cost avoidance and cost recovery initiatives.
  • •Partner with health plans to identify and contain costs through collaboration with national vendors for each recovery category.
  • •Develop annual budgets and projected targets for each national vendor and support achievement of annual savings.
  • •Evaluate and streamline processes, present trends and opportunities to senior management, and assist with implementation of action plans.

Pay and Benefits

Salary: USD 107,700 - 199,300 annually
Perks:Health Insurance401kEquityPaid LeaveHolidaysRemote Work

Key Requirements

  • •Bachelor’s degree in Accounting, Finance, Healthcare Management, or related field, or equivalent experience.
  • •6+ years of data analysis, finance, or accounting experience.
  • •Experience with government programs auditing and compliance monitoring programs (preferred).
  • •Project management experience (preferred).
  • •Ability to oversee cost recovery and cost containment initiatives against targeted project metrics.
Experience:6+ yearsHealthcarePayment integrityData analysisFinanceGovernment programs
Education:Bachelor's in Accounting, Finance, Healthcare Management, or related field
Skills:CollaborationAnalysisCommunicationProcess improvementStakeholder management

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn