Vice President, Payment Integrity - Remote

Overview

This role involves leading the Payment Integrity operations at Centene, focusing on claims audit and medical coding to enhance the health of communities.

In Short

• Direct and oversee claims audit operations.
• Manage payment integrity operations and initiatives.
• Develop and execute Payment Integrity strategies.
• Ensure accurate and timely operational reviews.
• Implement corporate policies and procedures.
• Identify and address analytical gaps in operations.
• Lead integration activities related to payment integrity.
• Collaborate with various departments for operational success.
• Maintain compliance with industry standards.
• Support the development of staff through management duties.

Requirements

• Bachelor's Degree in a relevant field; Master's preferred.
• 10+ years of experience in Managed Care or CMS.
• Experience in compliance, claims, and payment integrity.
• Management experience required.
• Strong analytical and strategic planning skills.
• Ability to implement corporate initiatives effectively.
• Excellent communication and leadership abilities.
• Proficiency in operational reviews and audits.
• Commitment to diversity and equal opportunity.
• Willingness to adapt to various work environments.

Benefits

• Competitive pay and comprehensive benefits package.
• Health insurance and 401K plans.
• Tuition reimbursement and paid time off.
• Flexible work schedules including remote options.
• Support for personal and professional growth.
• Access to innovative health solutions.
• Commitment to employee well-being.
• Diversity and inclusion initiatives.
• Opportunities for additional incentives.
• Equal opportunity employer.