$148,000.00 - $274,200.00 py; not specified; not s...
Hybrid
Payment integrity audit programs
Claims accuracy improvement
Reduce improper payments
Provide strategic leadership for the Audit Programs function within Payment Integrity, leading the design, execution, and continuous optimization of audit programs
Job Summary
Provide strategic leadership for the Audit Programs function within Payment Integrity, leading the design, execution, and continuous optimization of audit programs.
Oversee clinical, coding, pricing, and policy audit activities to reduce improper payments and improve claims accuracy across all applicable lines of business.
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.
Matching Summary
Provide strategic leadership for the Audit Programs function within Payment Integrity, leading the design, execution, and continuous optimization of audit programs.
Salary
$148,000.00 - $274,200.00 per year; Not specified; Not specified
Skills & Requirements
Must-have
payment integrity audit programs
claims accuracy improvement
reduce improper payments
enterprise payment integrity
audit program roadmap
performance standards and metrics
Nice-to-have
strategic leadership
continuous optimization
operational excellence
sustainable medical cost savings
culture of accountability
Key Requirements
Bachelor’s degree required
Master’s degree preferred
Health Information Management or coding credentials
Registered Nurse (RN) or higher qualification preferred
10+ years in Payment Integrity or related fields
5+ years managing prepay edits, postpay audits, or FWA programs