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Manager, Claims and Encounters

This job is available in 2 locations

Manager, Claims and Encounters

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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.

Oklahoma Complete Health, a Centene company, is committed to providing quality healthcare solutions to transform the health of Oklahomans.

At Oklahoma Complete Health, we are community advocates and change-makers in search of an inclusive culture grounded by our commitment to work-life balance, competitive compensation, and continuous career development. Join us and be a part of a collaborative, growing network of innovative thinkers delivering solutions at the local level.

***Must Reside in Oklahoma***

Position Purpose: Manage and coordinate staff engaged in business and strategic analysis. Oversee geographically distributed cross-functional team to analyze business process to link them to business application technology solutions.

  • Oversee the analysis of business processes and development of functional requirements and appropriately document and communicate captured information for validation and re-usability
  • Collaborate with IT to design and maintain changes to encounter systems, including ensuring system build content meets contractual requirements
  • Evaluate programming techniques, training needs, and select and implement various trainings
  • Advise and consult with plans and user departments, identifying problem areas, and determine and recommend procedural changes
  • Serve as the primary liaison for business unit operations and corporate IT, claims and encounter counterparts to ensure systems, processes and tools meet business requirements
  • Create and maintain re-usable policies, procedures and formats suitable to the new business technology development activities of the organization
Education/Experience: Bachelor’s degree in Healthcare Administration, IT or related field or equivalent experience. 5+ years of claims payment or encounters administration experience. Medicaid and/or Medicare experience preferred.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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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