Centene Corporation

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.

Position Purpose: Oversee operations, procurement opportunities, new product implementations and initiatives for assigned business unit or product line to meet strategic objectives.

• Responsible for day to day operations of assigned business unit or product line ensuring product strategy developed and key priorities are implemented.
• Execute projects and activities to ensure health plans are meeting all product goals.
• Provide day to day oversight of assigned business unit or product line.
• Collaborate with multiple stakeholders and business unit leadership to establish strategic vision, operational objectives, and policies and procedures ensuring compliance with state and federal contracts, related laws, regulations and executive orders.
• Deep understanding of managed care models (HMO, PPO, Medicaid, Medicare Advantage, Duals, SNPs).
• Familiarity with healthcare laws, reimbursement models, and value-based care initiatives.
• Perform duties as senior liaison between product line, other business units, corporate, and external stakeholders related to operational areas.
• Oversee day-to-day operations including claims processing, provider network management, member services, utilization management, and quality improvement.
• Ensure compliance with CMS, NCQA, HIPAA, and other regulatory bodies.
• Oversee implementation and optimization of health plan operations systems (e.g., claims adjudication platforms, CRM tools).
• Drive digital transformation initiatives to streamline operations.
• Understand and execute on key operational needs of assigned business unit or product lines.
• Oversight of relevant corporate business units to ensure the development and implementation of operational work processes and systems within product lines to senior management.
• Act as lead on new product implementations.

Education/Experience: Bachelor's Degree in Business Administration, Healthcare Administration, or related field required.

8+ years of operations, management, or administration experience in the Healthcare or Insurance industry required.

Experience with business development and knowledge of legislative and/or regulatory processes preferred.

Pay Range: $185,200.00 - $352,700.00 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, 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