Experience Inc. Jobs

You could be the one who changes everything for our 28 million members as a Customer Care professional at Centene. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:

Responsible for the development, implementation and management of business operations such as billing and enrollment, call center, customer service, etc. and related initiatives that impact membership for product lines and health plans. Manage service levels; identify service opportunities, new business implementations and product expansions.

*Applicants for this job have the flexibility to work remote from home anywhere in the United States.

Responsibilities include:

•Strategy development work, structuring identified and unidentified issues for resolution, researching, summarizing information and working with key stakeholders to provide the HP, EBOS, and IT Leadership with information to make sound and timely decisions.

•Drive action-based results with EBOS Leadership. Communicate complex information in a simple and compelling format.

•Team responsible for ensuring Executives understand current performance, trajectory and expected results. Works collaboratively with EBOS, IT and Health Plan leaders to assure alignment of the Regional Operating Plan and incentive programs.

•Owns communication plans relating to strategy and performance for Shared Service Operational Functions. Tracking strategic initiatives by monitoring progress towards achieving goals and benchmarks. Ensuring follow-through on the part of key players, and sustaining momentum needed to drive these initiatives. Ability to create and utilize systems (informal and formal) to communicate and disseminate information. Must effectively communicate upwards, laterally and downwards throughout the organization as well with external constituencies.

•Shared Service Program benefit realization

•Region-wide efforts to reduce complaints, grievances and appeals.

•Process Optimization and Standardization

Develop and implement programs centered on quality and operations excellence

Develop and monitor service levels to ensure compliance with state, federal, and company metrics and standards

Initiate ongoing and special projects including process improvement evaluations and analysis, department business development, ROI analysis, and annual satisfaction initiatives

Direct all membership related initiatives including identification of business need, strategy recommendation, project outline, management of deliverables, and ROI

Work collaboratively to facilitate the design, development and implementation of policies, procedures and practices related to service operations

Establish and maintain working relationships with external sources such as CMS for regulatory and compliance guidance

Develop and maintain collaborative relationships with health plans, other business units, IT partners, and oversee training and business processes as necessary

Experience/Experience:

Bachelor’s degree in Business or related field or equivalent experience. 7+ years of business operations (call center, enrollment, billing, payment processing, or similar operations) experience preferably in a managed care and/or Medicare environment. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff. Health insurance and project management experience 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: Director, Business Operations

LOCATION: Various, Florida

REQNUMBER: 1403830