Senior Reimbursement Analyst

You could be the one who changes everything for our 26 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: Develop and recommend provider reimbursement standards, policies, and guidelines that align with industry standards and state requirements. Serve as the key liaison between health plan network management, finance and contract implementation and configuration for reimbursement processes.

Research and analyze provider reimbursement methodologies and regulatory medical coding requirements to ensure alignment with state requirements.

Develop and maintain fee schedules as required by the state.

In collaboration with Finance, conduct impact analysis related to fee schedules or payment policy changes.

Serve as primary contact to the state for all provider reimbursement methodology issues.

Identify technological solutions to implement alternative payment solutions to improve cost and contract performance.

Develop standardized reimbursement payment solutions to improve, manage and predict unit cost performance

Oversee entire project life cycle, including deliverables, resource allocations, and implementation.

Develop improvement processes and methods used to implement new provider reimbursement for the business unit.

Education/Experience: Bachelor's degree in Business Administration, Healthcare Administration, or related field or equivalent experience. 5+ years of provider reimbursement and analysis experience. Experience with Medicare and Medicaid reimbursement methodology. Managed care experience and provider billing experience preferred.

The salary range for NY is: $51,600 - $92,900

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.