Process and Policy Analyst

at Centene Corporation in Springfield, Illinois, United States

Job Description

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: Perform and lead various analysis and interpretation to link business needs and objectives for assigned function and implement process improvements.

+ Lead the support of business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems

+ Review clinical policies to ensure accuracy with current benefit configuration

+ Recommend coding updates through the clinical review process

+ Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations, including improvements and revisions to business processes and requirements

+ Evaluate risks and concerns and communicate to management

+ Resolve issues and identify opportunities for process redesign and improvement

+ Identify ways to enhance performance management and operational reports related to new business implementation processes

+ Formulate and update departmental policies and procedures

+ Oversee all changes to departmental policies and procedures, including communicating and implementing the changes

+ Work on cross-functional projects across the organization

+ Coordinate with various business units and departments in the development and delivery of training programs

+ Serve as the subject matter expert on the assigned function product to ensure operational performance

+ Lead the identification and analysis of user requirements, procedures, and problems to improve existing processes

+ Develop, share, and incorporate organizational best practices into business applications

+ Ability to travel

Education/Experience: Bachelor’s degree in related field or equivalent experience. 6+ years of business process or data analysis experience, preferably in healthcare. Advanced knowledge of Microsoft Applications, including Excel and Access. Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies. Ability to recommend coding updates through the clinical review process and coding/clinical background highly preferred. Preferred understanding of how process details within implementation impact internal systems, members, and providers.

Pay Range: $82,600.00 – $148,700.00 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. 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.

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Job Posting: JC254368845

Posted On: Feb 16, 2024

Updated On: Mar 08, 2024

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