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Centene

Runs government-backed health insurance plans

Program Manager 3 - Payment Accuracy

Program ManagementPosted on Nov 3
Full-timeMissouri, USA$87.7k - $157.8k /yrRemote

About the Job

Requirements

  • A bachelor's degree in Business Administration, Healthcare Administration, or a related field, or equivalent experience.
  • At least 5 years of project implementation, product management, or program management experience.

Responsibilities

  • Promote program efficiency, service levels, and value by monitoring performance and identifying improvement opportunities and strategies.
  • Identify opportunities to increase efficiency, improve service levels, and ensure regulatory compliance through enhanced operations.
  • Develop strategies to realize improvement opportunities and ensure organizational prioritization and resource alignment.
  • Manage multiple projects through the full project life cycle, including requirements gathering, project planning and scheduling, obtaining and managing resources, budget management, execution, deployment, and closure.
  • Use corporate and industry-standard project management tools and techniques to manage projects.
  • Maintain project documentation, including action items, issue lists, and risk mitigation plans.
  • 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 to meet stakeholder expectations and company objectives.
  • Provide functional and technical knowledge regarding program requirements and operations.
  • Be responsible for governance communications and ceremonies.

Desired Qualifications

  • A master's degree.
  • Experience in managed care or prescription benefit management.
  • Experience with Amisys, Xcelys, or similar claims adjudication engines.
  • Knowledge and experience with Payment Accuracy programs within EDI Gateway Availity or similar programs.

About the Company

Centene

Runs government-backed health insurance plans

Centene runs government-backed health insurance plans in the United States, with Medicaid as its largest business alongside Medicare and Affordable Care Act Marketplace coverage. It is one of the largest Medicaid insurers in the country and also runs plans for people eligible for both Medicare and Medicaid, long-term care and children in foster care. States and the federal government pay Centene a set amount per member to manage care, and individuals buy its Ambetter Marketplace plans, often with federal subsidies. Centene contracts with local doctors, hospitals and pharmacies and keeps the difference between premiums and the cost of care. The company was founded in 1984 in Milwaukee and is headquartered in Clayton, Missouri.

Company size
10,001+
Company stage
IPO
Headquarters
Clayton, MO
Founded
1984

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