Supervisor, Business Analysis - Benefit Implementation/Configuration
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: The Benefit Configuration Supervisor will manage the team to implement benefit related changes for the CA Group Commercial, Medicare and Medi-Cal plans in ABS. This position will track and assign work to team, report project status and manage project workload to completion. The Benefit Configuration Supervisor is responsible for representing team and department in cross functional meetings related to benefit related changes/modifications and will work closely with the Plan Configuration Supervisor, Compliance and Product Development to ensure accurate implementation of benefits.
- Attend meetings related to new product or regulatory changes; implement regulatory and project related changes to plan benefit structure, ensures proper follow-up and resolution for all compliance and benefit related changes.
- Oversee and assign workload; work with analysts to create and refine internal P&Ps and workflows.
- Supervise, direct, and evaluate the activities of staff. Serve as a resource for staff and continuously cross-train to maximize knowledge, capabilities, and level of expertise.
- Identify opportunities to maximize department quality and increase operational efficiency. Identify and resolve operational gaps impacting benefit implementation and stakeholder experience.
- Answer and/or assist team in answering benefit configuration inquires and address issues identified by sales, brokers, customer contact department and other internal customers.
- Participate in SOX review/compliance; participate in audits and works closely with compliance as needed.
- Participate in projects related to system enhancement and UAT Testing.
Education/Experience:
- Bachelor’s degree in Business, Computer Science or equivalent experience.
- 4+ years of related operations and/or IT experience, preferably in healthcare. Strong understanding of relational database concepts.
- Experience with report and/or query development.
- Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.
- Working knowledge of CPT, HCPCS, ICD-10 coding with the ability to apply the codes to benefit categories preferred.
- Working knowledge of healthcare benefit structure and cost share application. Previous benefit configuration experience is a plus preferred.
- Overall understanding of the claim/benefit adjudication process. Previous experience with ABS is preferred.
- Proficiency in Microsoft applications; specifically, Microsoft Excel preferred.
- Experience with Healthcare related Compliance implementations preferred.
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. Total compensation may also include additional forms of incentives.
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