Centene is transforming the health of its 28 million members and is looking for a professional to support the implementation and ongoing operational maintenance of assigned product(s) or service area(s) to enhance operational effectiveness and improve member outcomes.
Requirements
- 2+ years of experience in Leading or supporting projects in the following areas: Benefits, Product Management, Marketing and Sales, Strategic Planning, and/or Project Management
- 2+ years of experience in Data analysis and process improvement in the following areas: Benefits, Healthcare or Regulatory/Government Affairs
- 2+ years of experience in Vendor management or oversight; preferably with healthcare vendors
- 2+ years of experience in customer service experience in a healthcare contact center or customer service environment dealing with claims, grievances pharmacy and appeals authorizations in one or more of the following: Medicare, Medicaid, PDP, Exchange etc.
- Other Experience in health care or managed care environment
- Other Experience working the state reporting, regulatory/government affairs
Responsibilities
- Creates and maintains reporting tools to effectively analyze and develop process improvement opportunities that enhance the operational effectiveness of the product(s) or service area(s).
- Assesses operational performance and escalations by tracking, analyzing and researching performance level expectations.
- Proactively identifies trends and root cause analysis to drive resolution of complex escalations; including communications and reporting.
- Creates reports and supports business review presentations to key stakeholders; including, but not limited to, Senior Leadership Team, Vendors and/or Government agencies.
- Manages projects including the implementations for delegated functions as needed.
- Collaborates with internal and/or external partners to execute assigned business objectives and initiatives.
- Ensures member or other stakeholder communications contain appropriate information, talking points and FAQs, and are effectively implemented.
Other
- Serves as the subject matter expert (SME) for the assigned product(s) or service area(s).
- Drives assigned operational aspects of the product(s)/service(s).
- Monitors assigned internal/external relationships to ensure compliance with contractual requirements.
- Develops effective relationships with key partners and stakeholders to influence and drive operational enhancements.
- Participates in and supports department and/or product strategic planning activities.
