Vice President II, Configuration Operations

Centene Corporation

About The Position

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. Position Purpose: Provides enterprise leadership and strategic oversight for benefit and provider payment configuration that supports accurate claims adjudication, benefit administration, and provider pricing across Medicare, Medicaid, and Marketplace lines of business and multiple platforms. This role ensures claims configuration, authorization and payment requirements, benefit rules, pricing logic, and system alignment collectively enable compliant, efficient, and scalable claims processing. Aligns operational execution with regulatory requirements, financial integrity, and enterprise strategy. The position is accountable for driving configuration excellence, ensuring system readiness to support evolving regulatory and business needs, and enabling operational performance that supports accurate, timely, and compliant claims outcomes. Establish and execute the enterprise strategy for claims configuration operations, including benefit configuration, authorization payment logic, and provider pricing. Serve as the accountable business owner for claims configuration platforms and pricing systems. Ensure configuration complies with CMS, state Medicaid agencies, Marketplace requirements, and contractual obligations. Drive continuous improvement to reduce claims payment errors and rework. Lead and develop high-performing configuration operations teams. Performs other duties as assigned. Complies with all policies and standards.

Requirements

Bachelor's Degree in Business Administration, Healthcare Administration, Information Systems or related field required.
10+ years of progressive leadership experience in healthcare, managed care, or health insurance operations including claims adjudication systems, benefit configuration, and provider pricing required.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Nice To Haves

Master's Degree preferred.

Responsibilities

Establish and execute the enterprise strategy for claims configuration operations, including benefit configuration, authorization payment logic, and provider pricing.
Serve as the accountable business owner for claims configuration platforms and pricing systems.
Ensure configuration complies with CMS, state Medicaid agencies, Marketplace requirements, and contractual obligations.
Drive continuous improvement to reduce claims payment errors and rework.
Lead and develop high-performing configuration operations teams.
Performs other duties as assigned.
Complies with all policies and standards.