Payment Integrity Lead: Data Mining & Cost Recovery Remote

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

Job summary

Centene Corporation in the United States (Illinois) seeks a seasoned cost recovery and cost containment specialist to oversee vendor performance and initiatives for Health Plans. You will drive cost avoidance, manage budgets, and present trends to Senior Management.

Required: Bachelor’s in Accounting/Finance/Healthcare Management or related field and 6+ years in data analysis, finance or accounting. Flexible schedules include remote, hybrid, field or office work.

Qualifications

• 6+ years of data analysis, finance or accounting experience.
• Experience with government programs auditing and compliance monitoring preferred.
• Project management experience preferred.

Responsibilities

• 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 for each recovery category
• Develop annual budget and projected target for each national vendor and assist them with achieving projected annual 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 the implementation of those plans
• 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 knowledge

Project management

Education

Bachelor’s degree in Accounting, Finance, Healthcare Management, related field or equivalent experience

Job description

Centene Corporation in the United States (Illinois) seeks a seasoned cost recovery and cost containment specialist to oversee vendor performance and initiatives for Health Plans. You will drive cost avoidance, manage budgets, and present trends to Senior Management.

Required: Bachelor’s in Accounting/Finance/Healthcare Management or related field and 6+ years in data analysis, finance or accounting. Flexible schedules include remote, hybrid, field or office work.