Senior Claims Research & Analysis Manager (Remote)

Centene Management Company LLC; United States; Remote; USD 108,000 - 199,000; Full time

Job summary

Centene Management Company LLC is seeking a Claims Analytics Manager to lead and mentor a team of Claims Business Analysts, delivering data-driven insights to improve processes and performance.

The role emphasizes root cause analysis, solution development, and cross-functional project coordination, with remote work options for residents in Florida. Benefits are included with competitive compensation.

Qualifications

• Bachelor’s degree in a related field or equivalent experience.
• 5+ years of experience in health plan operations, preferably with Medicare and/or Medicaid or equivalent business experience.
• Ability to deal with abstract variables and apply principles of logic or scientific thinking to define problems, collect data, establish facts, and draw valid conclusions.
• Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

Responsibilities

• Manage and mentor Claims Business Analysts.
• Collect, validate and analyze data to deliver business solutions.
• Monitor performance and develop & implement business solutions to address process and/or quality gaps.
• Utilize project management skills to work with cross functional teams on delivery of solutions.
• Promote change through sharing of best practices.
• Leverage automation to achieve desired results.
• Interface with and manage all organizational levels to mobilize commitment.
• Perform claim adjudication project analysis and preparation work flow management.
• Develop and implement required Process Bulletins.
• Identify automation opportunities to decrease spend levels.
• Reduce adjustment volume through root cause analysis and correction.

Skills

Data analysis

Leadership

Project management

Process improvement

Automation

Stakeholder management

Education

Bachelor's degree in a related field

Job description

Centene Management Company LLC is seeking a Claims Analytics Manager to lead and mentor a team of Claims Business Analysts, delivering data-driven insights to improve processes and performance.

The role emphasizes root cause analysis, solution development, and cross-functional project coordination, with remote work options for residents in Florida. Benefits are included with competitive compensation.