Business Analyst II - Payment Integrity

Centene Management Company LLC; United States; Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Job summary

Centene Management Company LLC in the United States seeks a professional to perform analysis linking business needs to objectives, support initiatives through data analysis, identify barriers, and assist with user acceptance testing of new systems. You will analyze user requirements, improve processes, lead cross‑functional problem solving, and help update policies.

A bachelor's degree and 2–4 years in healthcare data analysis are expected; remote/hybrid/work options are available as part of

Qualifications

• Bachelor's degree in related field or equivalent experience.
• 2-4 years of business process or data analysis experience, preferably in healthcare.
• Project management experience preferred.
• Experience with claims payment/analysis and knowledge of managed care information systems preferred.
• Knowledge of provider reimbursement methodologies preferred.
• Previous structured testing experience preferred.

Responsibilities

• Analyze business needs and link them to objectives.
• Support initiatives through data analysis and identify implementation barriers.
• Lead problem solving and coordinate efforts between business units.
• Assist with formulating and updating departmental policies and procedures.
• Comply with policies and standards.

Skills

Data analysis

Business process analysis

Healthcare domain knowledge

Requirements gathering

Testing/UA T

Problem solving

Stakeholder coordination

Education

Bachelor's degree in related field

Job description

Position Purpose: Perform various analysis and interpretation to link business needs and objectives for assigned function. Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems Identify and analyze user requirements, procedures, and problems to improve existing processes Perform detailed analysis on assigned projects, recommend potential business solutions and assist with implementation Identify ways to enhance performance management and operational reports related to new business implementation processes Develop and incorporate organizational best practices into business applications Lead problem solving and coordination efforts between various business units Assist with formulating and updating departmental policies and procedures Performs other duties as assigned Complies with all policies and standards

Education/Experience: Bachelor's degree in related field or equivalent experience. 2-4 years of business process or data analysis experience, preferably in healthcare. Project management experience preferred.

Benefits and Payment Configuration: Compliance Coding/Prepay Compliance (Payment Integrity): Bachelor's degree in related field or equivalent experience. 2+ years of business process analysis, preferably healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience. Knowledge of managed care information systems and experience in benefits, pricing, contracting or claims preferred. Knowledge of provider reimbursement methodologies preferred. Previous structured testing experience preferred.

Pay Range: $56,200.00 - $101,000.00 per year

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including:

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• a flexible approach to work with remote, hybrid, field or office work schedules

Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.