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Business Area: Clinical & Care Management

Job Type: Full time

Position Purpose: Provides advanced business and technical expertise to design, build, validate, implement, and support complex data solutions, reporting, applications, and automations. Serves as a subject matter expert in business systems, claims data, audit sampling, databases, and reporting platforms. Translates business, audit, and regulatory requirements into sustainable technical solutions; ensures data accuracy through testing and reconciliation; resolves complex production issues; and partners across business, technology, risk and control, and vendor teams. Independently leads technical work and guides other analysts.

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.

+ Develops ad-hoc reports to conduct data analysis and validation, including reconciliation of source data, business rules, sampling logic, calculations, and automated output for accuracy, completeness, and control compliance.

+ Confers with area/department to analyze current operational procedures and trends and identify problems, partnering with business, technology, risk and control, and vendors to manage requests, validate changes, and resolve complex issues.

+ Conducts business analysis and recommends technical alternative solutions to management as to course of action that best meets the organization's goals.

+ Research, evaluate and assess the financial and operational impact of issues identified in data/processes.

+ Analyzes requirements, procedures, and problems to automate processing or to improve existing business systems; develops applications, APIs, and automation that integrate data and reduce manual effort.

+ Creates and maintains multiuser, real-time, robust database and reporting solutions, including complex SQL queries, stored procedures, database structures, ETL processes, data pipelines, data models, and paginated and interactive reports supporting claims audit sampling, analytics, and automation; administers workspaces, gateways, deployment pipelines, service accounts, access, and security.

+ Acts as subject matter expert to provide business and technical expertise in requirements solicitation, system analysis, technical design, programming, testing, validation, and documentation of business applications/systems, including data flows, process maps, runbooks, testing evidence, and knowledge transfer materials.

+ May be responsible for monitoring and reporting to management on the status of departmental projects: Anticipates and identifies issues that could inhibit achieving the project goals and objectives, and implementing corrective actions and mitigation strategies; independently leads complex technical initiatives and manages priorities, milestones, risks, status, and implementation.

+ Provides oversight and resolves complex issues, optimizing performance, resolving problems, and providing timely follow- up on identified issues; owns production support, including monitoring, triage, root cause analysis, defect resolution, change implementation, and documentation.

+ Provides guidance and training to staff on process, procedures, technical solutions, documentation, and issue resolution.

Additional Responsibilities:

+ Performs other duties as assigned.

+ Complies with all policies and standards.

Education/Experience:

Bachelor's Degree in a related field or equivalent work experience in technical data analysis, database and application development, conducting system analysis meetings, developing system design documents, developing project plans with achievable milestones and deadlines, testing, validating, and supporting solutions in production, and mediating different department demands to gain approvals on system scope and design.

Master's degree in related field i.e., Mathematics, Computer Science, Information Systems, Data Analytics, etc may be considered in lieu of some of the required experience (not to exceed 2 years).

Candidate Experience:

+ Required 4+ years of experience in relevant programming to include SAS, SQL, VB.NET, or Oracle (or similar depending upon departmental requirements), preferably with advanced SQL and relational database development (MS SQL Server and/or Teradata), including database design, stored procedures, query performance tuning, ETL/data pipeline development, data validation, and troubleshooting; SAS, .NET/C#, or comparable technologies strongly preferred.

+ Required 3+ years of experience in related business analysis, preferably including translating requirements into technical designs and independently moving complex work from concept through production support.

+ Preferred hands-on experience with Power BI Desktop and Report Builder, Power BI workspaces, gateways, deployment pipelines, service accounts, access/security administration, APIs, and application development using .NET/C# or comparable technologies.

+ Preferred 3+ years of experience in healthcare claims, internal audit, payment integrity, regulatory reporting, or a comparable highly controlled data environment.

Licenses and Certifications :

+ Preferred Microsoft Power BI or Microsoft data platform certification, or comparable technical certification.

Pay Range: $87,700.00 - $157,800.00 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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