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Director, Operations

Work from home Full-time role Hiring

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.

This is a fully remote position, but candidates must be able to work on a Pacific Standard Time (PST) schedule to align with California-based teams and occasional in-person meetings or events.

We’re seeking a proven leader with experience in:

  • Provider network and data management
  • Pricing and benefit configuration
  • Claims operations

Managed care, insurance, Medicare/Medicaid experience preferred.

Position Purpose: Coordinate, negotiate and handle activities of the department and Senior Leadership within Operations in formulating and administering organization policies and procedures.

  • Manage work flow of the department and maintain production and quality standards for the department.
  • Ensure compliance with all related laws, regulations and executive orders.
  • Review and analyze reports, records and directives, and confer with staff to obtain data required for planning work function activities.
  • Establish the department’s strategic vision, objectives, and attendant policies and procedures for the organization.
  • Evaluate and implement improved procedures and practices for accomplishing the organization and department’s objectives and to ensure compliance with all related laws, regulations and executive orders.
  • Coordinate activities of assigned work function and/or department with related activities of other work functions and/or departments to ensure efficiency and proper prioritization.
  • Analyze reports and records on departmental and organizational activities and disseminate relevant information to business unit leaders for effective decision making.
Education/Experience: Bachelor's degree in Management or Business or equivalent experience. 4+ years experience in management, business, or contracting. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff. Managed care, insurance, Medicare or Medicaid experience preferred.Pay Range: $145,100.00 - $268,800.00 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

Originally posted on Himalayas

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