Senior Manager, Payment Integrity- Recovery Operations

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:
Provide oversight of post Claims Recovery Platform recovery execution, ensuring recoveries are fully realized through disciplined reconciliation, exception resolution, and recovery system oversight. This role maintains tight operational monitoring to prevent dropped, delayed, or lost recovery dollars and ensures recovery outcomes are accurate, complete, and audit ready.

• Own end-to-end post recovery execution, ensuring recoveries are completed accurately and timely.
• Maintain visibility and control over recovery inventory, including rolling balances, in flight recoveries, and completed recoveries.
• Performs financial reconciliation to confirm recoveries are fully realized and accurately reflected in systems.
• Identify and investigate recovery drops, failures, and anomalies to prevent lost or delayed dollars.
• Lead resolution of recovery exceptions, including coordination and closure of tickets.
• Escalate and resolve systemic recovery issues in partnership with Claims, Finance, Configuration, and Technology teams.
• Serve as the business subject matter expert for recovery systems, including Claims Recovery Platform and Enterprise Business Operations System coordination.
• Monitor recovery execution closely to ensure compliance, accuracy, and audit readiness.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:
Bachelor’s degree in Healthcare Administration, Business, Public Health, Health Information Management, or related field or equivalent work experience, required. Master’s degree preferred.

• 4+ years of leadership experience with direct reports.
• 6+ years of experience in data analysis, finance, accounting, or payment integrity recovery operations.
• Experience supporting government programs, auditing and compliance monitoring preferred.
• Payer claims systems experience required.
• Project management experience preferred.

Pay Range: $107,700.00 - $199,300.00 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