[Remote] Program Manager III - Recovery Operations/Payment Integrity

Note: The job is a remote job and is open to candidates in USA. Centene Management Company LLC is hiring a Program Manager III to lead recoupment claim inventory management and monitor payment integrity recovery automation. The role resolves operational issues and coordinates with program SMEs, IT, and Claims teams to improve recovery processes.

Responsibilities

• Identify opportunities to increase efficiency, improve service levels and to ensure regulatory compliance through enhanced operations
• Develop strategies to realize improvement opportunities, and ensure organizational prioritization and resource alignment
• Manage multiple projects through full project life cycle process including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure
• Utilize corporate and industry standard project management tools and techniques to effectively manage projects
• Maintain detailed project documentation as needed including action items, issues lists and risk mitigation plans
• Provide leadership and effectively communicate project status to all stakeholders, including executive summaries and presentations
• Negotiate with project stakeholders to identify and secure resources, resolve issues, and mitigate risks
• Lead cross-functional meetings with various functional areas to meet overall stakeholder expectations and company’s objectives
• Provide functional and technical knowledge regarding overall program requirements and operations

Skills

• Bachelor's degree in Business Administration, Healthcare Administration, related field, or equivalent experience
• 5+ years project implementation, product or program management experience
• Master's degree
• Managed care or prescription benefit management experience
• Experience driving initiatives within healthcare recovery operations, payment integrity, claims operations, revenue cycle, or related healthcare business functions

Benefits

• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• A flexible approach to work with remote, hybrid, field or office work schedules

Company Overview

Company H1B Sponsorship