Senior Manager, Payment Integrity - Data Mining Programs

NOBEL Women; Sacramento, Northern (CA, KY); Hybrid; USD 108,000 - 199,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K/Stock purchase

Tuition reimbursement

PTO + holidays

Flexible work schedule

Job summary

Centene in Sacramento is seeking a seasoned Cost Recovery and Cost Containment Analyst to oversee internal and external initiatives, aligning with forecasted savings goals. You will partner with health plans and national vendors to identify savings, develop annual budgets, and drive process improvements.

The role requires 6+ years in data analysis/finance/accounting, government program auditing experience, and strong project management.

Qualifications

• 6+ years of data analysis, finance or accounting experience.
• Experience with government programs auditing and compliance monitoring.
• Project management experience preferred.
• Project management experience preferred.

Responsibilities

• Oversee and monitor cost recovery and cost containment initiatives.
• Manage internal and external vendors cost avoidance and cost recovery initiatives.
• Partner with health plans to identify and contain cost with national vendors.
• Develop annual budget and targets for national vendors and assist achieving savings.
• Evaluate and streamline existing processes to reduce costs.
• Present trends and cost containment opportunities, recommend action plans and assist with implementation.
• Assist health plans in understanding rules around cost recovery.
• Monitor other departments’ performance 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

Education

Bachelor's degree in Accounting/Finance/Healthcare Management

Job description

Position Purpose:Oversee and monitor the performance of both internal and external cost recovery and cost containment initiatives according to targeted project metrics and forecasted recovery and cost avoidance goals for each Health Plan.

• 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

Education/Experience: Bachelor’s degree in Accounting, Finance, Healthcare Management, related field or equivalent experience. 6+ years of data analysis, finance or accounting experience. Experience with government programs auditing, and compliance monitoring programs preferred. Project management experience preferred.

Pay Range: $107,700.00 - $199,300.00 per year

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including:

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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