Senior Manager, Business & Systems Operations

Centene Corporation

Senior Manager overseeing healthcare systems, claims, reporting and provider contracts for Centene’s health plans. Improving operational accuracy, efficiency and system performance.

Posted 9/10/2026full-timeRemote • Montana • 🇺🇸 United StatesSenior💰 $107,700 - $199,300 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in health care operations, system administration, and claims administration, with a strong focus on process improvement and performance monitoring. Proficient in managing business specifications and overseeing system builds to ensure compliance with health plan and provider contract requirements.

Highest-signal resume keywords

Health Care OperationsSystem AdministrationClaims AdministrationMedicaid and Medicare CodingProcess Improvement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

System Performance MonitoringBusiness Requirements ManagementBenefit DesignReimbursement StrategiesContractingProvider Data Management

Soft Skills

Management ExperienceTeam LeadershipTraining and Development

Industry Keywords

Health Plan ComplianceClaims ProcessingAuto AdjudicationMarket Provider Contracting

About the role

Key responsibilities & impact

Identify, manage and oversee system and business requirements for new and existing business
Ensure performance meets health plan, state and provider contract requirements
Oversee system builds for new markets and products, including configuration and testing
Monitor and evaluate system performance trends and identify improvement opportunities
Oversee the timeliness and accuracy of reporting deliverables
Establish and manage business specifications for authorization and claims/encounters system infrastructure
Identify and implement process improvements across new business implementations, claims, encounters, auto adjudication, benefit specification testing and system integrity
Establish and manage special projects to improve organizational efficiency, productivity and accuracy
Oversee design and maintenance of market provider contract rate exhibits and configuration/testing of negotiated contracts

Requirements

What you’ll need

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Bachelor's degree in related field or equivalent experience
6+ years of health care operations, system administration, product/program management or claims administration experience
Experience with Medicaid and Medicare coding
Experience with benefit design
Experience with reimbursement strategies/methodologies
Previous management experience, including hiring, training, assigning work and managing staff performance
Contracting and provider data management experience preferred
Master's degree preferred

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation
Equal opportunity and diversity commitment