Program Manager II, Debt Recovery and Litigation Support

Centene Management Company; Pembroke Pines (FL); Remote; USD 68,000 - 124,000; Full time

Job summary

Ein etabliertes Unternehmen im Gesundheitswesen sucht einen erfahrenen Projektmanager, der die Verantwortung für die Verwaltung von Sammlungen und Forderungen übernimmt. In dieser Rolle werden Sie als Hauptansprechpartner fungieren, um die Effizienz und Qualität der Rückforderungsprozesse zu verbessern. Ihre Aufgaben umfassen die Koordination von funktionsübergreifenden Teams, die Entwicklung von Rückzahlungsvereinbarungen und die Unterstützung bei rechtlichen Aktivitäten. Sie werden in einem dynamischen Umfeld arbeiten, das Flexibilität bietet und auf die Bedürfnisse der Mitarbeiter eingeht. Wenn Sie eine Leidenschaft für das Gesundheitswesen und eine starke Projektmanagement-Hintergrund haben, ist dies die perfekte Gelegenheit für Sie.

Benefits

Gesundheitsversicherung

401K und Aktienkaufpläne

Studiengebührenrückerstattung

Bezahlte Freizeit plus Feiertage

Flexible Arbeitszeiten

Qualifications

• 3+ Jahre Erfahrung im Projektmanagement, vorzugsweise im Gesundheitswesen.
• Erfahrung in der Entwicklung, Implementierung und Gestaltung von Programmen.

Responsibilities

• Verwaltung des Sammlungs- und Forderungsprozesses.
• Koordination von funktionsübergreifenden Besprechungen zur Verbesserung der Rückforderungen.

Skills

Projektmanagement

Kommunikationsfähigkeiten

Verhandlungsfähigkeiten

Problemlösungsfähigkeiten

Excel-Funktionen (VLOOKUP, Pivot-Tabellen)

Education

Bachelor-Abschluss in einem verwandten Bereich

Tools

Projektmanagement-Tools

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Plan, organize, monitor, and oversee programs utilizing cross functional teams to deliver defined requirements and meet business needs and strategic objectives.

This Project Manager II will be supporting our Sunshine Health plan.They will be calling providers to collect on recoveries, track negative balance collections, repayment agreements, and supporting litigation activities.

In this Program Manager II role, you will:

• Manage the collection and provider receivables process
• Serve as the main point of contact within the organization for information on the collections inventory for all lines of business. Maintain an updated tracking system.
• Outreach to providers both written and telephonically to manage all activities related to the improving recoveries/receivables
• Research alternate payee information tying providers to current claims activities
• Coordinate cross-functional meetings to track and improve negative balance collections
• Assist with developing repayment agreements with providers to aid in the collection process
• Support the health plan by managing litigation activities, including interactions with legal professionals
• Manage Support business department initiatives that promote, quality, safety and cost of care opportunity
• Responsible for gathering requirements, creating plans and schedules, managing resources, and facilitate project execution and deployment.
• Utilize corporate and industry standard tools and techniques to effectively oversee programs according to department procedures.
• Maintain detailed business process documentation including meeting minutes, action items, issues lists and risk management plans as applicable
• Create and monitor all department deliverables to ensure adherence to quality standards including clinical reporting documents, related reference materials, and policy and procedure documentation.
• Communicate program status to management and key stakeholders.
• Identify resources, resolve issues, and mitigate risks.
• Identify requirements, procedures and problems to improve existing processes
• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and business objectives
• Provide leadership and effectively communicate project status to all stakeholders
• Negotiate with project stakeholders to identify and secure resources, resolve issues and mitigate risks
• Performs other duties as assigned
• Complies with all policies and standards

Required Education/Experience:

• Bachelor's degree in related field or equivalent experience.
• 3+ years of project management.
• Health care experience preferred.

Preferred:

• Health Care industry or Managed Care experience
• Experience with reconciliations
• Experience in provider recoveries and collections
• Experience in program development, implementation and design
• Previous experience working with legal professionals
• Excel functions like VLOOKUP, pivot tables, SUMIFS will be very beneficial

*Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States.Due to the needs of the business, schedule is 8am - 5pm ET, with some late hours if needed.*

Pay Range: $68,700.00 - $123,700.00 per year

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. Total compensation may also include additional forms of incentives.

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