Project Manager I - Payment Integrity

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:Plans, organizes, monitors, and oversees projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Responsible for coordination of health plan decision, necessary exclusions, letterset review, state / regulatory review, provider notification, and configuration of a policy or program
• Health Plan point of contact
• Facilitate and lead Monthly Touchpoint Calls with each plan
• Map out and follow-up on Implementation timeframes
• Act as the liaison on Q&A between the plan and Payment Integrity SMEs
• Coordination of letterset review, state / regulatory review, and provider notification​
• Track implementation decisions ​
• Submit configuration requests and communicate upon go-live.
• Utilize corporate and industry standard project management tools and techniques to effectively oversee projects.
• Assist with establishment and maintenance of corporate project management methodology and other department procedures.
• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.
• Effectively communicate project status to all stakeholders.
• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.
• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience:

• Bachelor's degree or equivalent experience.
• 0-2 years of project management experience.
• Account management experience strongly preferred.
• Experience working with and leading diverse groups and matrix managed environments.
• Healthcare experience strongly preferred.

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

Originally posted on Himalayas