Director, Claims Configuration

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Position Purpose: Oversee the claims configuration and pricing/benefits set up within the claims payment system ensuring accurate reflection of provider contracts and claims payments

• Ensures timely and accurate configurations and pricing/benefits set up for new business implementations
• Ensure changes in provider contracts are reflected in the claims payment system
• Collaborate with stakeholders to gather business requirments for system configurations and set up
• Identify and implement opportunities to automate processes to increase effectiveness and efficiency
• Oversee the evaluation and analysis of upcoming implementations and ensure successful and smooth transition into claims systems and processes

Education/Experience: Bachelor's degree in Business Administration, Health Care Administration, Information Technology or related field or equivalent experience. 7+ years of configuration, claims adjudication, pricing/benefits setup, or contracting experience.

Pay Range: $145,100.00 - $268,800.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.  Total compensation may also include additional forms of incentives.

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act