"Alerted.org

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:** Develop and recommend provider reimbursement standards, policies, and guidelines that align with industry standards and state requirements. Serve as the key liaison between health plan network management, finance and contract implementation and configuration for reimbursement processes.

+ Research and analyze provider reimbursement methodologies and regulatory medical coding requirements to ensure alignment with state requirements.

+ Develop and maintain fee schedules as required by the state.

+ In collaboration with Finance, conduct impact analysis related to fee schedules or payment policy changes.

+ Serve as primary contact to the state for all provider reimbursement methodology issues.

+ Identify technological solutions to implement alternative payment solutions to improve cost and contract performance.

+ Develop standardized reimbursement payment solutions to improve, manage and predict unit cost performance

+ Oversee entire project life cycle, including deliverables, resource allocations, and implementation.

+ Develop improvement processes and methods used to implement new provider reimbursement for the business unit.

+ Performs other duties as assigned

+ Complies with all policies and standards

**Education/Experience:** Bachelor’s degree in Business Administration, Healthcare Administration, or related field or equivalent experience. 5+ years of provider reimbursement and analysis experience. Experience with Medicare and Medicaid reimbursement methodology. Managed care experience and provider billing experience preferred.

Pay Range: $55,100.00 - $99,000.00 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