Description
Position Purpose: As part of Meridian Health Plan, this position supports Risk Adjustment programs and strategic initiatives by coordinating cross-functional efforts across clinical, operational, analytics, compliance, provider, and vendor teams. Responsibilities include supporting provider and member engagement initiatives, program reporting and performance monitoring, stakeholder coordination, and operational improvement initiatives that contribute to accurate risk adjustment outcomes and business objectives.
Key Details: This is an hourly role. Applicants residing in Illinois (greater Chicago area) highly preferred due to business need and in-person department meetings. 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.
Support business department initiatives that promote, quality, safety and cost of care opportunity including requirements gathering, creation of plans and schedules, obtaining and managing resources, and facilitating program execution and deployment.
Translate program data and reporting into clear, actionable insights for internal stakeholders and external clinical providers, including presenting risk adjustment trends, outcomes, and recommended next steps.
Utilize corporate and industry standard tools and techniques to effectively oversee programs according to department procedures.
Coordinates with the PMO and Compliance team on timeline(s), status updates, business requirements and deliverables.
Maintain detailed business process documentation including meeting minutes, action items, issues lists and risk management plans as applicable.
Create and monitor all department deliverables to ensure adherence to quality standards including clinical reporting documents, related reference materials, and policy and procedure documentation.
Communicate program status to management and key stakeholders.
Identify resources, resolve issues, and mitigate risks.
Identify requirements, procedures and problems to improve existing processes.
Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and business objectives.
Manage programs through the full program life cycle.
Performs other duties as assigned.
Complies with all policies and standards.
Education/Experience: Bachelor's Degree Bachelor’s degree in related field or equivalent experience required. 1+ years of project management or business process experience. Project management and health care experience preferred.
Additional Preferred Skills:
Experience supporting healthcare programs within Medicaid, Medicare, Commercial, or managed care environments.
Experience analyzing program performance metrics and reporting to support decision making and operational improvement.
Professional certification in project management, program management, process improvement, or Agile methodologies (e.g., PMP, CAPM, Scrum, Lean, or Six Sigma).
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
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
