Remote Senior Manager, Payment Integrity & Data Mining

Remote Co.; United States; Remote; USD 108,000 - 199,000; Full time

Job summary

Centene is seeking a Senior Manager, Payment Integrity - Data Mining Programs to oversee and optimize cost recovery and containment initiatives across health plans. This remote role supports multiple states with a data-driven approach and partnerships with national vendors.

You'll lead budgeting, monitor performance, present trends to Senior Management, and drive process improvements. A bachelor’s degree in accounting/finance or related field and 6+ years of analytics and project management

Qualifications

• Bachelor’s degree in accounting/finance/healthcare management or related field.
• 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

Accounting

Project management

Education

Bachelor’s degree in Accounting/Finance/Healthcare Management

Job description

Centene is seeking a Senior Manager, Payment Integrity - Data Mining Programs to oversee and optimize cost recovery and containment initiatives across health plans. This remote role supports multiple states with a data-driven approach and partnerships with national vendors.

You'll lead budgeting, monitor performance, present trends to Senior Management, and drive process improvements. A bachelor’s degree in accounting/finance or related field and 6+ years of analytics and project management