Regional Vice President, Claims Operations

Company: Centene Corporation
Location: Saint Louis
Posted on: September 13, 2020

Job Description:

Regional Vice President, Claims Operations Category Administrative & Operations support Location St. Louis, Missouri, US Full-time Job Id 1190550 Corporate

Position Purpose: Lead a large scale organization accountable for the accurate, timely and efficient processing of Claims. Set the strategic vision and objectives of the claims operations to drive innovation, higher operational performance and quality outcomes.

Set the strategic claims vision in compliance with federal, state and Company guidelines

Leverage industry best practices, technology innovations and process redesign elements into the strategic vision of claims to support the continued organic and inorganic growth of the company.

Direct day to day operations of the claims departments and ensure the claims are processed within established government and company guidelines.

Empower the claims leadership team and supports the department and ensure quality claims metrics and service level agreements are met

Collaborate with executive leadership from internal departments to ensure efficiency and proper prioritization of the claims adjudication process

Develop production and quality standards are met and stretch goals are established to drive sustainable long-term quality and efficiency models

Set service levels and increase real time prioritization and productivity capabilities

Drive innovation to Establish, evaluate, and implement processes and procedures to accomplish the organization’s and departments’ objectives

Ensure compliance with all state and federal claims payment laws and guidelines

Education/Experience : Bachelor’s degree in Business Administration, Management, or Finance; Master’s degree preferred. 10 years of experience in overseeing and developing claims operations, preferably in a managed care and/or Medicaid setting. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

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.

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Transforming the health of the community, one person at a time.

HEALTHCARE IS BEST DELIVERED LOCALLY Our local approach allows us to help members access high-quality, culturally sensitive healthcare services.

LOCAL COMMUNITY INVOLVEMENT IS KEY We invest in local communities and the lives of our members in as many ways as we can.

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Keywords: Centene Corporation, St. Louis , Regional Vice President, Claims Operations, Other , Saint Louis, Missouri