Senior Director, Claims Implementation (Remote)

Centene Corporation; United States; Hybrid; USD 148,000 - 274,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off

Flexible work arrangements

Job summary

Centene Corporation in the United States seeks a strategic leader to oversee the implementation of products and plans into Claims business units, ensuring alignment with corporate strategies, timelines, and models across new markets, reprocurements or regulatory changes.

You will direct the creation and maintenance of standard models, lead Claims and Configuration Operations during implementations, and provide input into operating models and business planning.

Qualifications

• Bachelor’s degree or equivalent; Master’s preferred.
• 7+ years of project management experience.
• 5+ years of Government Programs Managed Care experience in multiple areas of Operations (Claims, Provider/Mbr Services/Medical Management/ Network, etc). Medicaid Managed Care experience preferred.

Responsibilities

• Direct the creation and maintenance of standard models for the claims implementation approach.
• Responsible for all Claims and Configuration Operations functions during implementation phase.
• Provide strategic leadership and oversight of the claims business implementation processes; managing company adherence to standard implementation processes, including decision authority on BRD approvals with Claims Process Owner.
• Provide input into operating models; standard corporate functional and information system models, performance metrics, expected outcomes and plan impacts, as appropriate.
• Direct claims business implementations to meet budget, timeline and scope requirements.
• Provide input into the business planning process and develop timelines for New Health Plan Business Implementations.

Skills

Project management

Education

Bachelor’s degree in related field or equivalent experience

Master’s degree preferred

Job description

Centene Corporation in the United States seeks a strategic leader to oversee the implementation of products and plans into Claims business units, ensuring alignment with corporate strategies, timelines, and models across new markets, reprocurements or regulatory changes.

You will direct the creation and maintenance of standard models, lead Claims and Configuration Operations during implementations, and provide input into operating models and business planning.