Responsibilities

• Serves as the subject matter expert (SME) for the assigned product or service area
• Drives assigned operational aspects of the product/service
• Assesses operational performance and escalations by tracking, analyzing and researching performance level expectations
• 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
• 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
• Participates in and supports department and/or product strategic planning activities
• Manages projects including the implementations for delegated functions as needed
• Collaborates with internal and/or external partners to execute assigned business objectives and initiatives

Requirements

• Education/Experience: Required a Bachelor’s degree in business administration / related field or equivalent work experience.
• Required 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 or data analysis and process improvement in the following areas: Benefits, Healthcare or Regulatory/Government Affairs or vendor management or oversight; preferably with healthcare vendors or required 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.

Preferred

• Experience with Excel, Power BI, and Co-Pilot is preferred.
• Experience with LTC and Medicaid is also preferred.

Benefits

• 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.