Centene Corporation

Account Manager

• Responsible for creating and updating the generic/biosimilar pipeline report to identify cost-saving opportunities for purchasing generics/biosimilars
• Analyze data from AcariaHealth and Centene Pharmacy Services and collaborate with internal pharmacy teams to monitor preferred generics/biosimilars on Centene formularies
• Serve as the primary point of contact for generic/biosimilar manufacturers, leading price negotiations and reviewing contracts
• Track generic/biosimilar usage and conversions monthly, setting targets for the Therapeutic Interchange team
• Perform pricing comparisons between direct and wholesaler costs and work with the AcariaHealth procurement team to ensure accurate drug file updates
• Provide support for generic/biosimilar drug initiatives as needed
• Developing and implementing plans for generic/biosimilar products, including market assessment, pricing, and competitive analysis
• Establishing and maintaining relationships with key stakeholders, such as pharmaceutical manufacturers, wholesalers and internal stakeholders
• Monitoring industry trends and competitor activities to identify opportunities and threats
• Leading projects, including defining scope, managing resources, and ensuring quality
• Developing and executing strategic account plans to maximize sales and profits
• Using data analysis to identify opportunities
• Negotiating contracts with pharmaceutical manufacturers to meet sales goals
• Reporting market intelligence and progress to stakeholders
• Work cohesively with Operations, Procurement and Management in order to achieve sales and margin objectives

Account Manager, Generic/BioSimilar

Account Executive

• Supports the design of internal communications and promotional products
• Supports all creative projects involving multiple members of the Medicare Sales Operations department
• Follows vision, creative solutions, and delivers high quality designs
• Complies with all company policies and brand standards
• Performs other duties as assigned

Sales Execution Designer

Auditor

• Conduct audits to ensure compliance with Center for Medicare/Medicaid Services (CMS) regulations
• Identifies improper processes, research issues, and prepare reports on related issues
• Develop methodologies to conduct audits
• Prepare audit plans and conduct audit procedures
• Assist compliance director with vendor audits
• Prepare and draft audit reports of findings and recommendations
• Perform follow-up procedures to validate implementation and effectiveness of action plan
• Assist with other audits as needed

Auditor II

Data Analyst

• Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions.
• Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes.
• Interpret and analyze data from multiple sources including healthcare provider, member/patient, and third-party data.
• Lead the planning and execution of large-scale projects and new reporting tools, translating business goals into actionable solutions.
• Identify and resolve data, process, and technical issues and communicate root-cause with stakeholders as appropriate.
• Partner cross-functionally at all levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners.
• Independently engage with business leaders to understand market-specific levers and constraints.
• Leverage enterprise reporting tools to rapidly deliver data-driven insights and recommendations.
• Research key business problems and proactively identify opportunities for cost and utilization improvements through quantitative analysis.
• Communicate and present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required.
• Mentor junior analysts on analytic best practices and business need fulfilment.
• Delegate tasks to junior analysts, providing guidance and validation where required.
• Performs other duties as assigned.
• Complies with all policies and standards.

Data Analyst IV – Healthcare Analytics

Manager

• Provides leadership and direction in planning, developing, and maintaining Centene's IT service operations function
• Provides oversight to the major enterprise system management and event management tools
• Leads ITSM strategies, collaborating with disaster recovery and business continuity teams
• Manages overall performance and reliability of the ITSM team by establishing and implementing technical and operational performance standards
• Develops strategy and plan for the implementation and development of policies and procedures
• Defines and maintains service operations key performance indicators (KPI) metrics
• Oversees planning, hosting, and deployment of key operational activities for IT service and support teams
• Oversees operational activities per standard operating procedures such as batch processing, backup/recovery jobs, system health checks, etc.
• Manages staff hiring, training, performance reviews and provides leadership, technical guidance and coaching to IT Service team members

IT Service Manager

Customer Support

• Stays current with emerging trends, methodologies, and technologies in market research
• Proactively recommends enhancements, leads pilot initiatives, and conducts meta-research
• Serves as a subject matter expert (SME) within the research team
• Provides strategic guidance to Marketing, business partners, and external research agencies
• Synthesizes data from multiple sources to deliver clear, concise, and business-relevant recommendations
• Leads and executes research independently and in collaboration with agencies
• Effectively communicates insights and opportunities to senior leadership
• Evaluates trends and advancements in market research methods
• Designs and conducts qualitative and quantitative research
• Advises on strategic research agency relationships
• Develops and delivers story-driven presentations with clear recommendations

Customer Experience Research Strategist

Business Development Rep

• Build the company’s market position and increase revenue by directing and performing activities to locate, develop, and close new business opportunities
• Provide input and information related to the feasibility or desirability of new business opportunities
• Assist in the development of business/operational delivery models
• Work directly in the market to develop a detailed understanding of business opportunities
• Provide leadership and oversight of proposal development
• Manage activities related to new business implementation; develop work plan, monitor progress, establish performance measurements, track outcomes and adjust plan as appropriate to meet project objectives
• Analyze risks
• Develop mitigation and contingency strategies with key stakeholders
• Prepare reports for senior management on project progress and performance metrics
• Develop licensing objectives, strategies, policies and programs, negotiations and presentations for the acquisition of licensing opportunities and technologies
• Direct the organization's local business strategy
• Direct feasibility study processes to determine potential entry strategy of the organization into expansion markets
• Develop local key provider, advocate and community leader relationships
• Meet with regulators and elected officials when appropriate
• Prioritize and organize the region's business development initiatives
• Direct the business planning process and develop timely business plans

Senior Director, Business Development

• Lead, negotiate, and manage multiple hospital, large medical group, physician, school and/or ancillary contracting activities in accordance with Corporate, health plan, and state guidelines
• Oversee all activities of the contracting department
• Develop and implement a network development plan for an assigned region and set of providers and identify and initiate contact with potential providers
• Negotiate contracts with interested providers utilizing model provider agreements, and follow up on contracts
• Lead negotiations, rate modeling, implementation and ongoing monitoring of assigned group of providers to maximize business relationships and opportunities
• Oversee provider set-up and contract configuration to ensure accurate claims adjudication and facilitate the organization of provider focus groups
• Evaluate and monitor providers’ performance standards and financial performance of contracts
• Ensures compliance with national contracting standards, reimbursement standards, provider set-up rules, exception process and use of model contract language
• Perform financial analyses to identify medical cost improvement opportunities and develop and execute contracting action plans to achieve results
• Performs other duties as assigned
• Complies with all policies and standards

Manager, Provider Network Optimization

• Analyze integrated and extensive datasets to extract value affecting business decisions
• Work collaboratively with key business stakeholders to identify areas of value
• Develop, maintain, and troubleshoot complex scripts and reports using SQL, Microsoft Excel, or other analytics tools
• Contribute to the planning and execution of large-scale projects with limited direction from leadership
• Provide technical guidance to junior analysts

Data Analyst III – Appeals Reporting

Analyst

• Provides in-depth business knowledge and advanced technical support to one or more business areas through developed and ad hoc analysis/reporting
• Analyzes company functions, processes, and activities to improve computer-based business applications
• Performs application/system design and implementation
• Documents development requirements
• Consults with end users to test and debug applications to meet client needs
• Develops ad-hoc reports to conduct data analysis and validation
• Conducts business analysis and recommends technical alternative solutions
• Research, evaluate and assess the financial impact of issues identified in data/processes
• Creates multiuser, real-time, robust database solutions
• Provides oversight and resolves complex issues

Lead Tech Analyst

Communications

• Oversee specific Member Engagement & Communications initiatives to improve member engagement and retention.
• Execute Communications initiatives related to regulations, operations, and/or health education
• Provide strategic solutions to various initiatives while meeting compliance regulations and timelines.
• Develop and execute communication initiatives across creative/content development, regulatory reviews/approvals and distribution
• Collaborate with business partners, health plans and vendors on various communication initiatives gaining full alignment.
• Utilize a multi-channel communication approach including web, direct mail, email, text, etc.
• Build and maintain internal and external business relationships

Member Engagement and Communications Specialist

• responsible for driving the product performance function for assigned products across multiple lines of business
• serve as the primary contact for new product implementations and expansion of existing product lines
• develop policies and procedures and execute the specific business plan for new and existing products
• oversee the review of product performance and the analysis of the performance of products
• coordinate product improvement initiatives
• monitor and manage commercial product portfolio performance