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Senior Process Consultant - Claims Adjudication - Remote Available

Company: Centene Corporation
Location: Charlotte
Posted on: September 23, 2022

Job Description:

You could be the one who changes everything for our 26 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.Applicants for this position have the flexibility to work remote.Position Purpose: The Senior Process Consultant - Claims Adjudication is a senior level individual thought leader who will drive simplification and standardization across divisions of Centene and join in developing our process architecture and ownership consulting practice. This role will navigate process simplification to drive year-over-year KPI improvements across our nationwide portfolio of health plans and platforms. Executive presence and emotional intelligence are essential capabilities the Consultant will use to collaborate with subject matter experts and executive leaders across a national scope. They may develop peer relationships with Directors, Senior Vice Presidents, and other Senior Leaders as a participant in process governance for Claims.You will own the outcomes and maturation of our core claims process intended to accurately pay millions of claims per week serving 1 in 15 Americans. As you lead simplification between claims pre-adjudication edits through adjudication, pricing, and finalization, you will play a key role in improving the US health care system. You will work in a tightly focused team with executive process owners, two other process consultants focused on the phases of the claims life-cycle before and after adjudication, and a principal process consultant responsible for end-to-end outcomes across all phases of the claims life-cycle.As a master facilitator, you will lead highly complex or sensitive collaborative events, likely to include highly confidential future state planning. In addition to collaboration with operations and health plan stakeholders, you may also partner with technology architects, product owners, and development teams to obtain automation support for the process vision the architecture and ownership team has cast with you for your portion of the process.Your impact will foster a reputation as a trusted advisor at all levels of the organization. Your ability to answer the "Why" questions for any new process recommendation and help stakeholders through the "What-About" questions they need to understand builds trust. That trust drives the adoption of new simplified operating models.Education/Experience: A minimum of 6 years of related experience in driving process transformation and simplification within a large corporate environment. Experience facilitating of distributed team process workshops. Operating model design and merger integration experience within a managed care environment highly preferred. Demonstrated understanding of business process as it relates to automated, customer self-service, and manual processing in the end-to-end environment described in position responsibilities across Centene's ecosystems or at other managed care industry payers strongly preferred.A Bachelor's degree in health care management, quantitative or business field (e.g., statistics, mathematics, engineering, computer science). A Master's degree preferred.License/Certification: ASQ CMBB; ASQ CSSBB; Shingo Gold, Certified Lean Master Black Belt; Certification in one or more enterprise architecture practices preferred.Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.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.**TITLE:** Senior Process Consultant - Claims Adjudication - Remote Available**LOCATION:** Charlotte, North Carolina**REQNUMBER:** 1340850

Keywords: Centene Corporation, Charlotte , Senior Process Consultant - Claims Adjudication - Remote Available, Professions , Charlotte, North Carolina

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