Sr. Payment Integrity Specialist - Governance

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:
Lead Business Process Consultant provides management support and strategic guidance and expertise to business case development for enterprise level initiatives across many functional areas and leads larger scale, complex, cross-functional initiatives. Drives strategic recommendations for portfolio planning with an emphasis on proactive solutions. Involved in team level development activities, such as training, mentoring, and tracking department metrics.

• Mentors junior team members on duties and responsibilities with supervision from leadership. Leads all levels of staff who are responsible for initiatives included in the companies operating plan in order to support their success, development and effective completion and communication of their initiative.
• Oversee the pipeline of business cases and prioritize them based on strategic value, interdependencies, risk appetite, and available capacity.
• Ensure consistent methodology and rigor in business case development across all teams, providing quality assurance and coaching to Senior Business Process Consultants. Ensures that all approved business cases are transitioned to initiatives (both documentation and clear responsibilities for each initiative) and tracks ROI for launched projects and initiatives.
• Leads engagement and communications with senior and executive stakeholders, translating business pain points into strategic recommendations and ensures successful execution towards plan.
• Coordinates proactive collaboration across cross-functional teams to identify and proactively respond to stakeholder business problems.
• Leads larger scale, cross-functional initiatives that are intended to drive performance improvement, financial gains, customer satisfaction and improved compliance.
• Provides strategic and policy guidance on assigned initiatives so that all processes are considered for maximizing effective implementation and results.
• Organizes work teams, drives consensus and ensures end to end policy/process integrity to accomplish project work: including identification and confirmation of participants, consistent work team engagement and productivity, meeting facilitation, consensus building, recommendation documentation and implementation oversight.
• Assists functional and project leaders in areas as needed such as facilitation, analysis, process mapping, brain-storming, project management issues, etc.
• Writes and delivers communication to all levels of organization to ensure support, awareness and effectiveness of process improvement initiatives.
• Provides other related support as needed to improve the performance of the business.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:
Bachelor's Degree in a related field or equivalent experience required
Master's Degree in a related field preferred
7+ years experience managing, leading projects within a consulting, healthcare, and or related sectors required
Licenses/Certifications:
Certified Project Management Professional (PMP)-PMI preferred
Process quality certification 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