Senior Manager, Payment Integrity - Data Mining Programs

Centene Corporation•Remote-MO, MO

20h•$107,700 - $199,300•Hybrid

About The Position

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Requirements

Bachelor’s degree in Accounting, Finance, Healthcare Management, related field or equivalent experience.
6+ years of data analysis, finance or accounting experience.

Nice To Haves

Experience with government programs auditing, and compliance monitoring programs preferred.
Project management experience preferred.

Responsibilities

Oversee and monitor the performance of both internal and external cost recovery and cost containment initiatives according to targeted project metrics and forecasted recovery and cost avoidance goals for each Health Plan.
Manage internal and external vendors cost avoidance and cost recovery initiatives
Partner with health plans to identify and contain cost through collaboration with national vendors for each recovery category
Develop annual budget and projected target for each national vendor and assist them with achieving projected annual savings
Evaluate and streamline existing processes and implement new processes to reduce costs
Present trends and cost containment opportunities, recommend action plans, and assist with the implementation of those plans
Assist health plans in understanding the rules, regulations and processes around cost recovery
Monitor other departments’ performance and processes and evaluate for cost recovery
Compile and Present reporting packages for Senior Management on current cost avoidance and cost recovery initiatives
Performs other duties as assigned
Complies with all policies and standards