HireMO

Business Area: Administrative & Claims Operations

Job Type: Full time

Position Purpose: Provide direction and oversight for function(s) of Enterprise Business Operations within established enterprise, state, and federal compliance guidelines with a focus on continuous improvement.

Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Preferred experience focused on establishing clear governance structures across lines of business.

+ Develop workforce strategy that attracts, retains, and develops talent that meets the evolving needs of the organization.

+ Collaborate and coordinate with key stakeholders to ensure dependencies are well understood and addressed within the business operations ecosystem to allow success in operational objectives.

+ Drive adherence to service levels and compliance with state, federal, and enterprise metrics and standards.

+ Act as a key driver for change to support growth initiatives, continued business improvement and transformation centered on quality and operational excellence.

+ Develop and maintain collaborative relationships with health plans, other business units, IT partners, and regulators.

+ Direct all membership related initiatives including identification of business need, strategy recommendation, project outline, management of deliverables, and ROI.

+ Facilitate the design, development and implementation of policies, procedures and practices related to business operations in cooperation with key stakeholders.

+ Use data, technology and innovation to drive continuous improvement to identify, assess and resolve issues across business operations.

+ Serve as escalation point to minimize provider and member impact and ensure that expectations are consistently met.

+ Ability to travel up to 25%.

+ Performs other duties as assigned.

+ Complies with all policies and standards.

Education/Experience: Bachelor's degree required or equivalent related experience. 7+ years of operations management required. Experience leading large-scale efforts (change, implementation, digital/technology, financial management) through data analysis and insights required. 5+ years of healthcare experience in multiple areas of operations (Enrollment/Billing, Claims, Provider Data, Configuration, Member Services, Contact Center, Medical Management, Network/IT, etc.) preferred. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Certifications: Project Management Professional Certificate (PMP) and/or Lean Six Sigma Certification (e.g. green belt, black belt, master black belt or other) preferred.

Pay Range: $107,700.00 - $199,300.00 per year

At Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It's work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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

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Director, Business Operations

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