Senior Manager, Payment Integrity

Centene Corporation•St. David's, MO

1d•$107,700 - $199,300•Hybrid

About The Position

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. This role oversees and monitors 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.

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

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