Senior Manager, Payment Integrity – Vended Audit Programs
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Job Description
Senior Manager overseeing payment integrity audits and cost recovery programs for Centene, a healthcare organization serving 28 million members. Managing vendors, budgets, reporting, and cost-containment initiatives.
Responsibilities:
- Oversee and monitor internal and external cost recovery and cost containment initiatives against project metrics and forecasted recovery and cost avoidance goals for each Health Plan
- Manage vendors’ cost avoidance and cost recovery initiatives
- Partner with health plans to identify and contain costs through national vendors for each recovery category
- Develop annual budgets and projected targets for national vendors and assist them in achieving projected annual savings
- Evaluate and streamline existing processes and implement new cost-reduction processes
- Present trends and cost containment opportunities, recommend action plans, and assist with implementation
- Help health plans understand cost recovery rules, regulations, and processes
- Monitor other departments’ performance and processes and evaluate them for cost recovery
- Compile and present reporting packages for Senior Management on cost avoidance and cost recovery initiatives
- Perform other duties as assigned
- Comply with all policies and standards
Requirements:
- Bachelor’s degree in Accounting, Finance, Healthcare Management, related field, or equivalent experience
- 6+ years of data analysis, finance, or accounting experience
- Experience with government programs auditing and compliance monitoring programs preferred
- Project management experience preferred
Benefits:
- Competitive pay
- Health insurance
- 401K plan
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation
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