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
Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes.
- Interpret and analyze data from multiple sources including healthcare provider, member/patient, and third-party data.
- Support execution of large-scale projects with limited direction from leadership
- Identify and perform root-cause analysis of data irregularities and present findings and proposed solutions to leadership and/or customer
- Manage multiple, variable tasks and data review processes under direct supervision within targeted timelines
- Support the design, testing, and implementation of process enhancements and identify opportunities for automation
- Support multiple functions and levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners
Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. 0-2 years of experience in working with large databases, data verification, and data management. Working knowledge of SQL/query languages. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred. Preferred knowledge of modern business intelligence and visualization tools including Microsoft PowerBI.Provider
Experience in provider contracting, claims pricing, financial reporting/analysis, data modeling, statistical modeling, data science, or geospatial/reimbursement analysis preferredClinical
Experience in public health (epidemiology, biostatistics), population health, social determinants of health, data science, social science, or geospatial/ROI/financial analysis preferredFinance
Experience in Finance, Actuarial Science, or Accounting preferred. Experience using analytic techniques & tools to explore financial performance trends and/or reconciling financial data preferred.Fraud, Waste & Abuse
Experience in fraud/waste/abuse identification and investigation, provider billing, or clinical coding preferred; Experience with data mining, machine learning, artificial intelligence, or statistical modeling preferredRisk Adjustment
Experience in risk adjustment, clinical coding, financial reporting/analysis, or CMS/State encounters and regulatory file submissions preferred; Experience with data mining, population health, and statistical modeling preferredQuality
Experience with HEDIS, NCQA, Medicare Star Rating System, QRS, or other quality measures preferred; Quality auditing or analysis of call center performance preferred; Experience with data mining, population health, and statistical modeling preferredTools & Technology
Experience with report/dashboard development, data/report automation, self-service capabilities, data design and integration, or data quality and governance preferredRegional and HBR Analytics
Experience with emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired.
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.