Senior Manager, Payment Integrity

🔥 12 hours ago

🌵 Arizona, Florida, +3 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🌲 North Carolina – Remote 🏰 Missouri – Remote 🤠 Texas – Remote

💵 $107.7k - $199.3k / year

⏰ Full Time

🟠 Senior

👔 Manager

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Healthcare Insurance • Non-profit • Social Impact

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• 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.

🎯 Requirements

• Bachelor’s degree in Accounting, Finance, Healthcare Management, 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.

🏖️ Benefits

• health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules