Centene Corporation
Join to apply for the
Vice President, Payment Integrity
role at
Centene Corporation 1 day ago Be among the first 25 applicants Join to apply for the
Vice President, Payment Integrity
role at
Centene Corporation Get AI-powered advice on this job and more exclusive features. Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.
Applicants for this role will have the flexibility to work remotely anywhere in the Continental United States.
Position Purpose
Direct and oversee claims audit operations and medical code editing scenarios. Oversee payment integrity operations, including pilots, new business, transformative initiatives, and payment policies.
Develop and execute Payment Integrity strategies, end-to-end process automation, optimization and management. Oversee various functions of the Payment Integrity department for accurate and timely operational reviews and final reviews. Develop corporate policies and procedures and implement corporate initiatives. Identify and prioritize analytical gaps between the current-state and industry best practices; implement solutions to generate business value. Chart the course for integration activities related to payment integrity and other assigned functions in alignment with organization objectives.
Education/Experience
Bachelor's Degree in Business Administration, Finance, Accounting, Criminal Justice, Economics or related field required. Master's Degree preferred. 10+ years of Managed Care or CMS related experience, including compliance, claims, payment integrity, or special investigation experience required. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff required. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
Pay Range $223,200.00 - $422,900.00 per year
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 Seniority level
Seniority level Not Applicable Employment type
Employment type Full-time Job function
Job function Other Industries Hospitals and Health Care and Insurance Referrals increase your chances of interviewing at Centene Corporation by 2x Get notified about new Vice President jobs in
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Vice President, Payment Integrity
role at
Centene Corporation 1 day ago Be among the first 25 applicants Join to apply for the
Vice President, Payment Integrity
role at
Centene Corporation Get AI-powered advice on this job and more exclusive features. Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.
Applicants for this role will have the flexibility to work remotely anywhere in the Continental United States.
Position Purpose
Direct and oversee claims audit operations and medical code editing scenarios. Oversee payment integrity operations, including pilots, new business, transformative initiatives, and payment policies.
Develop and execute Payment Integrity strategies, end-to-end process automation, optimization and management. Oversee various functions of the Payment Integrity department for accurate and timely operational reviews and final reviews. Develop corporate policies and procedures and implement corporate initiatives. Identify and prioritize analytical gaps between the current-state and industry best practices; implement solutions to generate business value. Chart the course for integration activities related to payment integrity and other assigned functions in alignment with organization objectives.
Education/Experience
Bachelor's Degree in Business Administration, Finance, Accounting, Criminal Justice, Economics or related field required. Master's Degree preferred. 10+ years of Managed Care or CMS related experience, including compliance, claims, payment integrity, or special investigation experience required. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff required. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
Pay Range $223,200.00 - $422,900.00 per year
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 Seniority level
Seniority level Not Applicable Employment type
Employment type Full-time Job function
Job function Other Industries Hospitals and Health Care and Insurance Referrals increase your chances of interviewing at Centene Corporation by 2x Get notified about new Vice President jobs in
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Pacific, MO $175,000.00-$225,000.00 1 week ago Senior Vice President, US Environmental and Engineering Services
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St Louis, MO $100,000.00-$110,000.00 5 days ago Assistant Vice President of Fundraising, Endurance Events - Midwest
Kansas City, MO $100,000.00-$110,000.00 5 days ago Missouri, United States $133,753.00-$180,959.00 1 week ago Director of Sales and National Account Management (Food & Snacks)
Springfield, MO $150,000.00-$175,000.00 4 days ago Missouri, United States $122,200.00-$183,300.00 4 days ago Missouri, United States $120,900.00-$205,500.00 20 hours ago Missouri, United States $120,900.00-$205,500.00 20 hours ago Regional Director of Operations - Healthcare
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St Louis, MO $175,000.00-$210,000.00 23 hours ago Missouri, United States $185,200.00-$352,700.00 2 days ago St Louis, MO $340,000.00-$380,000.00 1 day ago Regional Sales Director (Remote-based role)
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We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr