Payment Integrity Specialist – Regulatory

🔥 0 minutes ago

🌽 Illinois, North Carolina, +2 more states – Remote

🌽 Illinois – Remote 🌲 North Carolina – Remote 🏰 Missouri – Remote 🤠 Texas – Remote

💵 $87.7k - $157.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

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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

• leads business case development for proposed initiatives • supports the strategic planning process • ensures initiatives support the strategic business plan • provides strategic and policy guidance on assigned initiatives • organizes work teams, drives consensus and ensures end to end policy/process integrity • performs detailed analysis of data, workflows, policies, procedures, organization of staff, and skills • writes and delivers communication to all levels of organization • complies with all policies and standards

🎯 Requirements

• Bachelor's Degree in a related field or equivalent experience required • Master's Degree in a related field preferred • 6+ years managing projects required • Experience in health care and/or insurance preferred • Certified Project Management Professional (PMP)-PMI required • Process quality certification preferred

🏖️ Benefits

• competitive pay • 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