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.
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.
This position is fully remote; however, candidates must be able to work Pacific Standard Time (PST) hours, as the role supports the state of Oregon.
The ideal candidate has business analysis and claims experience, experience in Amisys, strong data interpretation and root cause analysis skills, proficiency in Excel, SQL, Golden, and experience tailoring communications/findings to different audiences. Experience with healthcare benefits, payment configuration, encounters, Payment Integrity (or other editing systems), or ABS is a plus.
Position Purpose:
Perform various analysis and interpretation to link business needs and objectives for assigned function.
- Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems
- Identify and analyze user requirements, procedures, and problems to improve existing processes
- Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations
- Identify ways to enhance performance management and operational reports related to new business implementation processes
- Coordinate with various business units and departments in the development and delivery of training programs
- Develop, share, and incorporate organizational best practices into business applications
- Diagnose problems and identify opportunities for process redesign and improvement
- Formulate and update departmental policies and procedures
- Serve as the subject matter expert on the assigned function product to ensure operational performance
- Ability to travel
- Performs other duties as assigned.
- Complies with all policies and standards.
Education/Experience:
Bachelor’s degree in related field or equivalent experience. 4-6 years of business process or data analysis experience, preferably in healthcare. Project management experience preferred.
Benefits and Payment Configuration: Bachelor’s degree in related field or equivalent experience. 4+ years of business process analysis, preferably in healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience. Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies. Knowledge of managed care information or claims payment systems preferred. Previous structured testing experience preferred.
Encounters: Bachelor’s degree in related field or equivalent experience. 4+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry or 3+ years of managed care encounters experience. Experience with encounters or claims business analysis experience in healthcare, preferably managed care or Medicaid. Knowledge of Amisys or other claims system, HIPAA transactions (i.e. 837, 999, 824, 277) and SQL Scripting 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
