Vice President, Claims Configuration Operations
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Connecticut • Florida • United States
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Salary
💰 $227,700 - $431,400 per year
Job Level
About the role
- Lead 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 within established government and company guidelines
- Set the strategic claims vision in compliance with federal, state and Company guidelines
- Oversee 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
- Develop, 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 all state and federal claims payment laws and guidelines
Requirements
- 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
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims processingclaims adjudicationquality standardsproduction standardsaudit outcomesstrategic visioncomplianceperformance managementprocess implementationefficiency improvement
Soft Skills
leadershipcollaborationorganizational skillscommunicationprioritizationmanagementtrainingstaff developmentproblem-solvingdecision-making