Payment Integrity Consultant

Centene Corporation; Florida; Hybride; USD 70 000 - 126 000; Plein temps

Avantages offerts par ce poste

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements

Résumé du poste

Centene Corporation seeks a Business Process Consultant to lead large-scale, cross-functional initiatives across health care and insurance domains. You will assist business case development, optimizing policy, process and technology alignment to deliver performance gains and compliance.

The role requires 5+ years of relevant experience and strong training, presenting and facilitation skills. A remote/hybrid/field/office schedule is available, with competitive benefits and growth opportunities.

Qualifications

• Bachelor's Degree in a related field or equivalent experience.
• Master's Degree in a related field preferred.
• 5+ years health care, insurance or related experience.
• Demonstrated experience and skill in training, presenting and facilitating required.

Responsabilités

• Lead large scale, cross-functional initiatives.
• Assist business case development to assess opportunities, risks and ROI.
• Facilitate alignment of policy, process and technology for future needs.
• Provide policy guidance for end-to-end process integrity.
• Organize teams, drive consensus, establish project plans and timelines.
• Analyze data, workflows, policies and staff capabilities to propose solutions.
• Support project work using Excel, PowerPoint, Visio and MS Project.
• Lead staff and assist other project leaders as needed.
• Write and deliver communications to stakeholders to ensure buy-in and awareness.

Connaissances

Training

Presenting

Facilitating

Formation

Bachelor's degree

Master's degree preferred

Outils

Excel

PowerPoint

Visio

MS Project

Description du poste

Position Purpose

The Business Process Consultant leads large scale, cross-functional initiatives.

• Assists business case development for those proposed initiatives to which are assigned to ensure adequate assessment of opportunities, risks and return on investment.
• Facilitates the optimization of business unit performance by enhancing alignment of policy, process and technology and designing/implementing for future business needs as well.
• Leads large scale, cross-functional initiatives that are intended to drive performance improvement, financial gains, customer satisfaction and improved compliance.
• Provides policy guidance on assigned initiatives so that end-to-end processes are considered for maximizing effective implementation.
• Organizes work teams, drives consensus and ensures end-to-end policy/process integrity to accomplish project work including: identification and confirmation of participants, establishment of a project plan, consistent work team engagement and productivity, meeting facilitation, consensus building, recommendation documentation and implementation oversight.
• Performs detailed analysis of data, workflows, policies, procedures, organization of staff, skills and offer potential solutions in order to execute initiatives.
• Supports the project work by utilizing project management software such as, but not limited to, Excel, PowerPoint, Visio, and Microsoft Project.
• Leads all levels of staff who are responsible for initiatives included in the company’s operating plan in order to support their success, development and effective completion and communication of their initiatives.
• Assists other project leaders in specific areas as needed such as facilitation, analysis, process mapping, brain-storming, project management issues, etc.
• Writes and delivers communication to all levels of organization to ensure support, awareness and effectiveness of process improvement initiatives.
• Possesses and utilizes knowledge and experience leveraging IT solutions.
• Provides other related support as needed to improve the performance of the business.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience

Bachelor's Degree in a related field or equivalent experience required

Master's Degree in a related field preferred

5+ years health care, insurance or related experience required

Demonstrated experience and skill in training, presenting and facilitating required

Pay Range: $70,100.00 - $126,200.00 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.

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