Vice President, Retrospective Programs (Remote)

Centene
Missouri
Workplace: RemoteFull timeUSD 188,900 - 359,800 annuallyFunction: Executive & General ManagementExperience: 10+ yearsEducation: bachelorsSkills: ["Executive leadership","Communication","Stakeholder management","Operational excellence","Cross-functional collaboration"]

Lead enterprise retrospective risk adjustment operations across Medicare, Marketplace, and Medicaid, owning strategy and execution for chart retrieval, coding operations, coding quality, supplemental data feeds, and retrospective analytics. Oversee internal teams and vendors, drive compliance and operational excellence, manage chart-to-claim linkage and audit readiness, and collaborate across analytics, claims, encounters, data integrity, compliance, finance, and local markets to deliver accurate, timely, sustainable outcomes.

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FursaFursa
Centene
Centene
2 days ago

Vice President, Retrospective Programs (Remote)

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Job Summary

Lead enterprise retrospective risk adjustment operations across Medicare, Marketplace, and Medicaid, owning strategy and execution for chart retrieval, coding operations, coding quality, supplemental data feeds, and retrospective analytics. Oversee internal teams and vendors, drive compliance and operational excellence, manage chart-to-claim linkage and audit readiness, and collaborate across analytics, claims, encounters, data integrity, compliance, finance, and local markets to deliver accurate, timely, sustainable outcomes.
Location: Missouri
Workplace: Remote
Employment Type: Full time
Job Function: Executive & General Management
Seniority: Sr. Director level

Key Responsibilities

  • •Lead enterprise retrospective program strategy and execution across internal teams and vendor partners.
  • •Establish and maintain an end-to-end operating model with clear roles, accountabilities, performance expectations, escalation paths, and decision rights.
  • •Oversee chart retrieval operations to ensure timely, complete medical record collection aligned to regulatory timelines and program goals.
  • •Drive vendor oversight for retrieval and coding, including performance, coding accuracy and quality monitoring, contract deliverables, SLAs, issue resolution, and corrective actions.
  • •Lead coding quality assurance and retrospective analytics work, partnering with Analytics to develop dashboards and performance reporting while representing the program in governance forums.

Pay and Benefits

Salary: USD 188,900 - 359,800 annually
Equity and Bonus:Equity
Perks:Health Insurance401kEquityPaid Leave

Key Requirements

  • •Bachelor’s degree in Healthcare Administration, Business, Finance, Clinical Discipline, Health Information Management, Analytics, or a related field.
  • •10+ years of progressive healthcare leadership experience, including risk adjustment, provider engagement, clinical documentation improvement, quality, claims, vendor management, or related healthcare operations.
  • •Experience leading enterprise programs across multiple markets and lines of business.
  • •Demonstrated success leading strategic initiatives, provider-facing programs, vendor partnerships, and cross-functional teams.
  • •Strong knowledge of risk adjustment methodologies, healthcare operations, provider documentation, and regulatory requirements.
Experience:10+ yearsHealthcareMedicareMedicaidMarketplaceRisk adjustmentVendor management
Education:Bachelor's in Healthcare Administration, Business, Finance, Clinical Discipline, Health Information Management, Analytics, or related field
Skills:Executive leadershipCommunicationStakeholder managementOperational excellenceCross-functional collaboration

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