Remote Claims Research & Analysis Manager (Florida)

Centene Corporation; United States; A distancia; USD 108.000 - 199.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Descripción de la vacante

Centene Corporation is seeking an experienced Claims Analyst to lead claims analysis and research, mentor analysts, and develop data-driven solutions to improve health plan operations. The role emphasizes root-cause analysis and cross-functional collaboration.

Applicants must reside in Florida and be authorized to work in the U.S. The company offers a comprehensive benefits package and a flexible remote/hybrid/work-schedule approach, with opportunities to optimize automation and control costs.

Formación

• Bachelor’s degree in a related field or equivalent experience.
• 5+ years of experience in health plan operations, preferably Medicare/Medicaid.
• Leadership experience managing cross-functional teams and staff.

Responsabilidades

• Manage and mentor Claims Business Analysts.
• Collect, validate and analyze data to deliver business solutions.
• Monitor performance and implement solutions to address gaps.
• Utilize project management to coordinate cross-functional delivery.
• Promote change through sharing of best practices.
• Leverage automation to achieve results.
• Interface with all organizational levels to mobilize commitment.
• Perform claim adjudication project analysis and workflow management.
• Develop and implement required Process Bulletins.
• Identify automation opportunities to reduce spend.
• Reduce adjustment volume through root cause analysis and correction.

Conocimientos

Leadership

Data analysis

Project management

Process improvement

Educación

Bachelor's degree

Herramientas

SQL

Excel

Descripción del empleo

Centene Corporation is seeking an experienced Claims Analyst to lead claims analysis and research, mentor analysts, and develop data-driven solutions to improve health plan operations. The role emphasizes root-cause analysis and cross-functional collaboration.

Applicants must reside in Florida and be authorized to work in the U.S. The company offers a comprehensive benefits package and a flexible remote/hybrid/work-schedule approach, with opportunities to optimize automation and control costs.