Position Purpose: Oversee operations, and business strategy utilizing cross-functional departments to meet strategic objectives with a focus on No Surprises Act (NSA) Independent Dispute Resolution (IDR) operations, including Federal IDR arbitration and applicable state IDR processes.

Key Details: 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. Preferred experience with NSA and appeal disputes.

• Develop and manage methodologies for tracking, identifying and problem-solving issues, interpreting and presenting program results and insights, and developing data-driven analysis approach for clients related to NSA IDR operations and outcomes
• Perform data analysis from a variety of data sources to evolve the metrics used to measure effectiveness and return on investment of all current and new product activity including IDR outcomes and fees
• Collaborate with staff to identify internal and external customers and their expectations, initiate process changes to increase quality, decrease costs and improve staff, provider and member satisfaction while ensuring compliance with applicable NSA IDR requirements
• Facilitate and support operations staff in the planning, achievement, and tracking of the organizations key strategic initiatives to create a positive impact on organizational scorecard including end-to-end IDR process
• Serve as an internal resource and advisor on improvement activities and as a resource for NSA IDR requirements and processes
• Explore new approaches to work processes by utilizing quality improvement techniques to eliminate waste and re-work and improve the accuracy, timeliness, and efficiency of IDR operations
• Able to travel up to 25%

Education/Experience: Bachelor’s degree Business Administration, related field, or equivalent experience. 4+ years experience in operational business processes or data analysis, preferably in the managed care or insurance industry. Practical experience implementing continuous improvement via Six Sigma or Total Quality Management (TQM) is desirable. Experience working within a matrix environment preferred.

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