Program Manager – PA Governance, Optimization

🔥 0 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $87.7k - $157.8k / year

⏰ Full Time

🟠 Senior

🔴 Lead

📋 Program 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

• Responsible for leading enterprise‑wide Prior Authorization (PA) governance and optimization efforts • Lead large‑scale, cross‑functional PA governance initiatives • Oversee all aspects of PA program planning, management, and execution • Drive the enterprise‑wide PA optimization cycle to plan • Ensure ad‑hoc PA requests are appropriately triaged, prioritized, and executed • Drive large‑scale initiatives by coordinating the work of project managers and business analysts • Create and maintain comprehensive timelines, workplans, and deliverables • Identify implementation risks early and partner with functional leaders to develop mitigation plans • Develop and maintain executive‑level dashboards and reporting • Prepare concise, decision‑ready materials for Program Steering Committees and Executive Leadership • Partner with PHCO Analytics to monitor post‑implementation impact • Track utilization or spend anomalies following go live • Proactively manage program‑level risks, dependencies, forecasts, and interdependencies • Serve as the first point of escalation for PA program issues and risks • Align stakeholders around data‑based prioritization, PA governance standards, and enterprise decision frameworks • Create and deliver best‑practice guidance and training

🎯 Requirements

• Bachelor’s degree in related field or equivalent experience required • 8+ years of Program or Project Management experience required • Previous experience as a lead in a functional area, managing cross-functional teams on large scale projects or supervisory experience including hiring, training, assigning work, and managing the performance of staff required • Proficiency in MS Office applications and project management tools required • Healthcare experience and/or managed care experience preferred • Project Management Professional (PMP) or Program Management Professional (PgMP) 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