Payment Integrity & Cost Optimization Lead (Remote)

Centene Corporation; Illinois; Hybrid; USD 108,000 - 199,000; Full time

Benefits offered by this job

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off

Job summary

Centene Corporation is seeking a Cost Recovery and Containment professional to oversee performance of internal and external initiatives aimed at cost recovery and avoidance across health plans. You will manage vendor relationships and collaborate with national partners to achieve annual savings.

The role includes budgeting, process optimization, trend reporting to senior management, and ensuring compliance with applicable rules and policies.

Qualifications

• 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.

Responsibilities

• Oversee and monitor cost recovery and cost containment initiatives.
• Manage internal and external vendors cost avoidance and cost recovery initiatives.
• Partner with health plans to identify and contain cost through collaboration with national vendors.
• Develop annual budget and projected target for each national vendor and assist them with achieving projected savings.
• Evaluate and streamline existing processes and implement new processes to reduce costs.
• Present trends and cost containment opportunities, recommend action plans, and assist with implementation.
• Assist health plans in understanding the rules, regulations and processes around cost recovery.
• Monitor other departments’ performance and processes and evaluate for cost recovery.
• Compile and present reporting packages for Senior Management on current cost avoidance and cost recovery initiatives.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

Data analysis

Finance

Accounting

Education

Bachelor’s degree or equivalent

Job description

Centene Corporation is seeking a Cost Recovery and Containment professional to oversee performance of internal and external initiatives aimed at cost recovery and avoidance across health plans. You will manage vendor relationships and collaborate with national partners to achieve annual savings.

The role includes budgeting, process optimization, trend reporting to senior management, and ensuring compliance with applicable rules and policies.