Payment Integrity Business Analyst II

Centene Corporation; Michigan; Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Holidays

Flexible schedules

Job summary

Centene Corporation in Michigan is seeking a Business Process Analyst to link business needs with objectives for the assigned function through data analysis and interpretation. You will identify requirements, examine processes, and support system implementations.

Preferred candidates have 2+ years in healthcare process analysis, strong Excel skills, experience with ticketing systems, and knowledge of managed care information systems. Salary range: $56,200–$101,000 per year.

Qualifications

• 2+ years of business process analysis experience, preferably healthcare.
• Knowledge of managed care information systems and claims/payment domains.
• Structured testing experience is preferred.

Responsibilities

• Support business initiatives through data analysis and testing of new systems.
• Identify and analyze user requirements, procedures, and problems to improve processes.
• Perform detailed project analysis and recommend business solutions.
• Enhance performance management and operational reports for new processes.
• Develop and incorporate best practices into business applications.
• Lead problem-solving and coordination across business units.
• Assist with formulating and updating departmental policies and procedures.
• Performs other duties as assigned and complies with policies.

Skills

Analytical thinking

Root cause analysis

Excel proficiency

Requirements gathering

Data analysis

Ticketing systems

Education

Bachelor's degree or equivalent

Tools

Ticketing systems

Job description

Position Purpose

Perform various analysis and interpretation to link business needs and objectives for assigned function.

Key Details

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Preferred qualifications include experience in Payment Integrity and healthcare claims auditing, medical coding, strong analytical and root cause analysis skills, proficiency in Excel, and experience working with ticketing systems.

• 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+ 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.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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, and 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