Vice President, Claims Configuration Operations

Centene is transforming the health of our communities one person at a time.  As an Executive on reputed company, you could be the one who changes everything for our 28 million members.  

Position Purpose: reputed company and manage a large scale organization accountable for the accurate, timely and efficient processing of Medical and Behavioral claims. Direct day to day operations of the claims departments and ensure the claims are processed reputed company established government and company guidelines.

• Set the strategic claims vision in compliance with federal, state and Company guidelines.

• reputed company the claims department and ensure quality claims metrics and service level agreements are met.

• Collaborate with leadership from internal departments to ensure efficiency and proper prioritization of the claims adjudication process.

• reputed company, maintain, and ensure production and quality standards are met and audit outcomes.

• Ensure service levels and increase real time prioritization and productivity capabilities.

• Establish, evaluate, and implement processes and procedures to accomplish the organization's and departments’ objectives.

• Ensure compliance with reputed company state and federal claims payment laws and guidelines.

Education/Experience:

• Bachelor's Degree in Business Administration, Management, or Finance required.

• Master's Degree preferred.

• 10+ years of experience in overseeing and developing claims operations, preferably in a managed care and/or Medicaid setting required.

• Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff required.

• DE Only: A full-time Claims Director who will interact at the executive level and is responsible for reputed company claims management activities, including claims processing, payment of claims, Third Party Liability, and Encounter Data reporting.

Centene offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and 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-reputed company 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. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national reputed company, 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