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Medicare Operations Performance Manager

Centene

This is a Full-time position in Clayton, MO posted May 2, 2021.

Medicare Operations Performance Manager Position Purpose:
– Oversee Claims Configuration & Processing performance and Key Performance Indicator adherence.

– Partner with Shared Services areas to develop and lead action and/or mitigation plans to address performance issues.

– Intake Medicare Claims and/or Product related issues from shared services & health plan partners, identifying root cause & resolution.

– Serve as Medicare liaison for short-term operational corrections and longer-term process improvement initiatives.

– Oversee and monitor Medicare Claims Configuration & Processing performance (such as dashboarding, KPIs, action plans to meet goal, etc.).

– Lead escalation & resolution for issues related to Claims Configuration, Claims Processing, Product requirements, and Product-specific Operational Improvements.

– Serve as operations subject matter expert for all Claims & Product items, utilizing matrix leadership over Shared Services areas & other Medicare Solutions teams.

Education/Experience: Bachelor’s degree in related field or equivalent experience required.

5+ years of Claims Configuration, Claims Processing, Product Development, Medicare Operations Claims experience is required.

Strong analytics skills along with experience in project management, quality or process improvement required.

License/Certification: N/A 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.

Health Insurance Operations USA-Missouri-Clayton Medicare Full-time

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