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Centene Corporation Staff Vice President, Claims Configuration in Chesterfield, Missouri

Position Purpose:

  • Oversee the implementation and maintenance of business processes and systems and all activities related to claims configuration, ensuring 99+% quality, alignment and compliance with Company objectives, various regulations and contracts.

  • Oversee all claims configuration activities for change management requests, expansions and new business.

  • Lead ongoing optimizations of the platform, enhancements and large projects to improve quality and efficiency.

  • Develop and implement business processes and systems to deliver efficient and high-quality operations results claims configuration.

  • Collaborate with IT, markets and others to integrate major initiatives and resolve issues. Provide risk mitigation strategy development to ensure business requirements are met.

  • Manage and oversee claims configuration system design to ensure requirements are reflected within the contact management system and integrated into various parts of data management, including credentialing and configuration.

  • Oversee the auditing and quality review of related business processes.

  • Partner with multiple stakeholders and business unit leadership teams to establish strategic vision, operational objectives and policies and procedures ensuring compliance with Company objectives, State and Federal regulations, NCQA standards and health care contracts.

  • 25% travel required.

Education/Experience:

Bachelor’s degree in Business Administration, Computer Science, or related field. 10+ years of business operations, claims, credentialing, provider services, or provider contract management, project management, supply chain, quality, lean or manufacturing experience. Experience in the managed care environment preferred but not required. Minimum 3+ years of supervisory/management experience including responsibilities for hiring, training, assigning work and managing performance of staff is required. Experience managing large scale teams preferably in IT, Provider Services, Provider Contracting, Manufacturing, Supply Chain or system related functions is preferred. Must be able to communicate effectively, develop staff to build capability/bench strength and have the ability to work across multiple teams.

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.

TITLE: Staff Vice President, Claims Configuration

LOCATION: Chesterfield, Missouri

REQNUMBER: 1191322

COMPANY: Administrative & Operations support

POSITION TYPE: Both

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