Senior Director, Provider Data Process Owner

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.
 

This is a fully remote position and can be located anywhere in the US.

Position Purpose:

Enterprise Business Operations Services (EBOS) provides shared operational services across our Medicaid, Marketplace, and Medicare lines of business and markets.  Provider Data Excellence (PDE) is one these services and includes comprehensive provider data management and credentialing capabilities.

This leader is expected to identify and drive improvements and consistency in end-to-end PDE processes, across lines of business, platforms, and markets, irrespective of EBOS’ control or ownership of the process.  Improvements could be in metrics such as provider data accuracy, timeliness, operating costs; identifying best practices and influencing consistent adoption; or even stopping an initiative that is no longer a priority.  Improvements will be a mix of short-and-mid term practical innovations that bring value relatively quickly, and longer-term transformational change including participating as a leader in a provider data lifecycle technology selection and implementation.

This position requires deep prior subject matter expertise and demonstrated success in large scale health care payer environments, relationship and trust-building to influence without clear organizational authority, ability to articulate a plan and develop a business case that compels action, and willingness to accept accountability and inspire others to relentlessly improve.  Other internal stakeholders include but are not limited to Network Operations, EBOS Claims and Configuration, Business Technology Services, Lines of Business, and Health Plan leadership.

• Improves accuracy and timeliness as demonstrated by industry-standard metrics.
• Ensures PDE Shared Services is leveraging scale and servicing cost effectively as compared to a more decentralized and non-standard operating model.
• Directs the execution of process oversight projects utilizing best practice methodologies for all process improvements, including process mapping and process design.
• Researches and develops best practices, policies, procedures, and goals in compliance with internal and external guidelines.
• Creates and maintaining dashboards, communications, and strategies to improve effectiveness.
• Establishes strong collaborative relationships with all functional units and their leaders.
• Complies with all policies and standards.
• Serves as lead and advocate on cross functional initiatives related to business and technology improvements.
• Performs other duties as assigned.
• Works closely with our operations teams and other stakeholders to make improvements to the lifecycle.

Education/Experience:

Bachelor's Degree in Business Administration/Healthcare Administration/Business or a related field required

Master's Degree in a related field preferred

10+ years relevant experience required

3+ years management experience required

5+ years of experience in large scale / healthcare payer provider data management processes highly preferred. Including Medicaid, Marketplace, and Medicare lines of business

Pay Range: $145,100.00 - $268,800.00 per year

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