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: The Program Manager leads enterprise‑wide initiatives focused on governing, monitoring, and improving adherence to utilization management (UM) turnaround times (TAT). This role ensures TAT standards are clearly defined, measured, and met through disciplined program management, cross‑functional coordination, and proactive risk and issue management.
Responsibilities:
Lead large‑scale, cross‑functional programs supporting UM turnaround time (TAT) governance and improvement, including working with organizational leaders on restructuring and realignment of teams to meet regulatory and operational TAT requirements.
Oversee all aspects of UM TAT program planning, management, and execution, including scope, schedule, budget, dependencies, and readiness for implementation.
Create comprehensive timelines and ensure project teams develop and maintain deliverables aligned to UM TAT standards, regulatory timelines, and internal service‑level expectations.
Drive complex UM regulatory alignment initiatives by coordinating the work of project managers and business analysts across Operations, Clinical, Benefit Operations, Compliance, Analytics, and Technology teams.
Ensure workstreams are sequenced and integrated appropriately to avoid downstream impacts to authorization decision timelines and member/provider experience.
Create and maintain executive‑level dashboards and scorecards that track turnaround time performance, trends, and compliance with regulatory and internal standards.
Partner with analytics teams to develop ongoing post‑implementation reporting that monitors TAT outcomes, identifies bottlenecks, and highlights emerging risks.
Create and maintain tracking mechanisms for open questions and documentation of status and decisions. Ensure clear visibility into in‑flight work and progress toward TAT improvement goals.
Prepare and deliver concise, decision‑ready materials for Program Steering Committees and Executive Leadership, including TAT performance updates, root cause analysis, and recommended actions.
Proactively manage risks, dependencies, resource constraints, and forecasts that may jeopardize turnaround time commitments.
Serve as the first point of escalation for TAT issues; work directly with project teams to resolve operational, process, or technology barriers impacting timely authorization decisions.
Develop and implement mitigation plans to address systemic delays and prevent recurrence.
Create and deliver best‑practice guidance, standard workflows, and training related to TAT expectations for indirect reports, peers, and stakeholders.
Partner with training teams to develop and update materials that reinforce TAT and other UM governance standards and operational consistency.
Effectively communicate TAT program goals, progress, risks, and outcomes to stakeholders at all levels, translating business, operational, and technology impacts into clear, actionable insights.
Ensure alignment across stakeholders on authorization turnaround expectations, accountability, and continuous improvement priorities.
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