Program Manager III – Recovery Operations, Payment Integrity

🔥 0 minutes ago

🐊 Florida, Illinois, +5 more states – Remote

🐊 Florida – Remote 🌽 Illinois – Remote 🐎 Kentucky – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🚗 Michigan – Remote 🏰 Missouri – Remote

💵 $87.7k - $157.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Program Manager

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

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

• Lead recoupment claim inventory management and BOT automation monitoring • Ensure Payment Integrity Amisys, Facets, Xcelys, and ABS recovery processes operate as expected • Resolve inventory and BOT automation issues in a timely manner • Review savings BOT automation issues to identify and address potential concerns • Collaborate with recoupment program SMEs, IT, and Claims teams • Identify opportunities to increase efficiency, improve service levels, and ensure regulatory compliance • Develop strategies to realize improvement opportunities and align organizational priorities and resources • Manage multiple projects through the full project life cycle, including requirements gathering, project plans and schedules, resource and budget management, execution, deployment, and closure • Use corporate and industry-standard project management tools and techniques • Maintain project documentation, action items, issue lists, and risk mitigation plans • Lead and communicate project status to stakeholders through executive summaries and presentations • Negotiate with stakeholders to secure resources, resolve issues, and mitigate risks • Lead cross-functional meetings • Provide functional and technical knowledge regarding program requirements and operations

🎯 Requirements

• Bachelor’s degree in Business Administration, Healthcare Administration, related field, or equivalent experience • 5+ years project implementation, product or program management experience • Managed care or prescription benefit management experience preferred • Preferred experience driving initiatives within healthcare recovery operations, payment integrity, claims operations, revenue cycle, or related healthcare business functions • Master’s degree preferred

🏖️ Benefits

• Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Competitive pay • Potential additional forms of incentives