Senior Manager, Payment Integrity

🔥 0 minutes ago

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

🌽 Illinois – 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

🛡️ 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

• Oversee and monitor internal and external cost recovery and cost containment initiatives against project metrics and recovery/cost avoidance goals for each Health Plan • Manage internal and external vendors’ cost avoidance and cost recovery initiatives • Partner with health plans and national vendors to identify and contain costs for each recovery category • Develop annual budgets and projected targets for each national vendor and assist with achieving projected annual savings • Evaluate and streamline existing processes and implement new cost-reduction processes • Present trends and cost containment opportunities, recommend action plans, and assist with implementation • Help health plans understand rules, regulations, and processes related to cost recovery • Monitor other departments’ performance and processes and evaluate them for cost recovery • Compile and present reporting packages to Senior Management on cost avoidance and cost recovery initiatives • Perform other duties as assigned • Comply with all policies and standards

🎯 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 • Ability to oversee cost recovery and cost containment initiatives • Ability to manage internal and external vendors • Knowledge of rules, regulations, and processes around cost recovery • Ability to develop budgets, projected targets, and reporting packages

🏖️ Benefits

• Competitive pay • 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 • Additional forms of incentives may be included in total compensation