Description
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.
Remote — U.S. nationwide.
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.
Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and act as a lead/resource for other Data Analysts. This Internal Audit Claims role supports claims audit execution through sampling, executive reporting, QA/reconciliation, Power BI/dashboard support, automation validation, bot/AI enablement, and repeatable management-ready analytics.
Support Internal Audit Claims analytics, including recurring claims audit sampling, executive reporting, AuditWell support, Power BI dashboard support, error/CAP trend analysis, and repeatable management-ready analytics.
Extract, transform, reconcile, and validate large healthcare claims datasets across enterprise data sources, including claims, provider, member, financial, operational, and audit-related data.
Perform structured QA, reconciliation, tie-outs, and validation of claims audit reporting, sampling outputs, dashboards, automation results, and executive-ready deliverables.
Develop and maintain recurring reports, dashboards, and analytical deliverables using SQL, Power BI, Excel, Snowflake, Teradata, MS SQL Server, or similar data warehouse / business intelligence tools.
Partner with audit, data analytics, IT, and business stakeholders to translate reporting, sampling, and automation needs into repeatable data processes, documentation, and validated outputs.
Support automation, bot, AI, and process-improvement initiatives through requirements translation, testing support, output validation, documentation, and controlled implementation.
Identify data issues, trends, process gaps, and reporting improvement opportunities; communicate findings clearly to management and support timely resolution.
Assist with training and mentoring other Data Analysts.
Preferred Skills:
Advanced SQL experience, including extracting, joining, reconciling, and validating large datasets from enterprise data warehouse environments.
Power BI experience, including Power BI Desktop, Power BI Service, workspace/report maintenance, refresh validation, access/security coordination, and service-account-based reporting processes.
Healthcare claims analytics experience strongly preferred, especially experience with post-pay claims data, claims processing systems, audit/compliance reporting, or quality review processes.
Experience with Snowflake, Teradata, MS SQL Server, EDW, or similar enterprise data platforms.
Strong data quality and reconciliation mindset, including structured tie-outs, report validation, issue documentation, and validation of automated reporting outputs.
Experience supporting automation, ETL, API-based processes, C#, .NET, Python, Alteryx, or similar workflow/process-improvement efforts preferred.
Ability to translate technical findings into concise, management-ready explanations for audit leadership, business stakeholders, and cross-functional partners.
Required Education/Experience: Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or data analysis experience.
By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.
Pay Range: $70,100.00 - $126,200.00 per yearCentene 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
