Sr. Manager Payment Integrity - Health Plan Concierge at Centene

This role is designed for a seasoned healthcare operations leader with a deep background in payment integrity and managed care. The ideal candidate has at least 6 years of experience navigating the complexities of claims accuracy, pre-pay edits, and fraud/waste/abuse programs. You should be a "bridge builder" who can take complex data insights and translate them into clear communication for providers and internal senior leadership. The position offers a high degree of autonomy and impact, serving as a strategic leader for the Health Plan Concierge vertical. It is a fully remote role (specifically looking for talent in MO or TX) with a broad salary range and a comprehensive benefits package that includes stock purchase plans and tuition reimbursement. It’s an excellent opportunity for someone who enjoys high-level troubleshooting and stakeholder management within a large-scale national payer environment. **You might be a good fit if you:** * Have 4+ years of experience leading teams and managing direct reports. * Are an expert in Medicaid/Medicare reimbursement methodologies and regulatory compliance. * Feel comfortable presenting program performance and risk mitigation strategies to executive leaders. * Effectively resolve complex provider disputes by identifying root causes through data analytics.