Senior Manager, Payment Integrity

About the Role

The ideal candidate will have experience in data analysis, finance, or accounting, as well as project management skills. The ability to partner with national vendors and develop annual budgets and projected targets is crucial. The Senior Manager will also evaluate and streamline existing processes, implementing new ones to reduce costs and improve overall performance.

What You Will Do

• Oversee the performance of internal and external cost recovery and cost containment initiatives
• Develop and implement strategies to achieve projected annual savings
• Partner with health plans to identify areas of cost containment
• Manage internal and external vendors, including cost avoidance and cost recovery initiatives
• Develop annual budgets and projected targets for national vendors
• Evaluate and streamline existing processes, implementing new ones to reduce costs
• Present trends and cost containment opportunities, recommending action plans and assisting with implementation
• Assist health plans in understanding rules, regulations, and processes around cost recovery
• Monitor other departments' performance and processes, evaluating for cost recovery opportunities
• Compile and present reporting packages for Senior Management on current cost avoidance and cost recovery initiatives
• Develop and maintain relationships with national vendors and health plans

What We Are Looking For

• Bachelor's degree in Accounting, Finance, Healthcare Management, or a related field
• 6+ years of experience in data analysis, finance, or accounting
• Experience with government programs auditing and compliance monitoring preferred
• Project management experience preferred
• Strong analytical and problem-solving skills
• Excellent communication and interpersonal skills
• Ability to work in a fast-paced environment and prioritize multiple tasks
• Strong attention to detail and organizational skills
• Experience with cost recovery and cost containment initiatives
• Knowledge of healthcare regulations and compliance

Nice to Have

• Experience with data mining programs and cost avoidance initiatives
• Familiarity with health plan operations and cost containment strategies
• Certification in a related field, such as accounting or project management
• Experience working with national vendors and developing annual budgets

Benefits and Perks

• Competitive salary
• Comprehensive benefits package, including health insurance, 401K, and stock purchase plans
• Tuition reimbursement and paid time off, plus holidays
• Flexible approach to work, with remote, hybrid, field, or office work schedules
• Opportunities for professional development and growth
• Collaborative and dynamic work environment
• Recognition and reward for outstanding performance

• To stand out in this role, highlight your experience with data analysis and project management, as well as your knowledge of healthcare regulations and compliance.
• Be prepared to provide specific examples of cost recovery and cost containment initiatives you've led or been a part of in previous roles.
• Familiarize yourself with Centene's approach to workplace flexibility and be prepared to discuss how you can work effectively in a remote or hybrid environment.
• Emphasize your ability to communicate complex ideas and strategies to both technical and non-technical stakeholders.
• Research the company's values and mission, and be prepared to discuss how your own values and goals align with those of Centene Corporation.
• Be prepared to discuss your experience working with national vendors and developing annual budgets and projected targets.
• Highlight any certifications or continuing education you've pursued in related fields, such as accounting or project management.