高级经理，支付完整性 - 数据挖掘项目
Senior Manager, Payment Integrity - Data Mining Programs
你可能是为我们的2800万会员带来改变的人。Centene正在通过一个个个体，改善社区的健康状况。作为一家多元化、全国性的组织，你将享受到具有竞争力的福利，包括对工作灵活性的新视角。
职位目的：
根据针对每个健康计划的目标项目指标和预测的回收及成本节约目标，监督和监控内部和外部的成本回收和成本控制计划的绩效。
- 管理内部和外部供应商的成本节约和成本回收计划
- 与健康计划合作，通过与全国供应商协作来识别和控制成本
- 为每个全国供应商制定年度预算和预期目标，并协助他们实现年度预期节约
- 评估并优化现有流程，实施新流程以降低成本
- 呈现趋势和成本控制机会，推荐行动计划，并协助实施这些计划
- 协助健康计划理解成本回收相关的规则、法规和流程
- 监督其他部门的绩效和流程，并评估其成本回收情况
- 编制并向高级管理层汇报当前成本节约和成本回收计划的报告包
- 完成其他指派的任务
- 遵守所有政策和标准
教育/经验：
会计、金融、医疗管理或相关领域的学士学位，或同等经验。6年以上数据分析、财务或会计经验。有政府项目审计和合规监控经验者优先。有项目管理经验者优先。
薪资范围：每年107,700.00 - 199,300.00美元
Centene提供全面的福利包，包括具有竞争力的薪酬、健康保险、401K和股票购买计划、学费报销、带薪休假及节假日，以及远程、混合、现场或办公室工作的灵活工作安排。实际薪酬将根据个人技能、经验、教育和其他法律允许的与工作相关因素（包括全职或兼职状态）进行调整。总薪酬可能还包括其他形式的激励。福利可能受项目资格限制。
Centene是一家平等机会雇主，致力于多元化，并重视我们各自的不同之处。
查看英文原文
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.
Position Purpose:
Oversee and monitor the performance of both internal and external cost recovery and cost containment initiatives according to targeted project metrics and forecasted recovery and cost avoidance goals for each Health Plan.
- Manage internal and external vendors cost avoidance and cost recovery initiatives
- Partner with health plans to identify and contain cost through collaboration with national vendors for each recovery category
- Develop annual budget and projected target for each national vendor and assist them with achieving projected annual savings
- Evaluate and streamline existing processes and implement new processes to reduce costs
- Present trends and cost containment opportunities, recommend action plans, and assist with the implementation of those plans
- Assist health plans in understanding the rules, regulations and processes around cost recovery
- Monitor other departments’ performance and processes and evaluate for cost recovery
- Compile and Present reporting packages for Senior Management on current cost avoidance and cost recovery initiatives
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience:
Bachelor’s degree in Accounting, Finance, Healthcare Management, related field or equivalent experience. 6+ years of data analysis, finance or accounting experience. Experience with government programs auditing, and compliance monitoring programs preferred. Project management experience preferred.
Pay Range: $107,700.00 - $199,300.00 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
Originally posted on Himalayas