Senior Director, Duals Business Operations

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 role. Candidates may reside anywhere within the continental U.S. The ideal candidate will have extensive experience with Medicare and Medicaid operations, with Duals program experience highly preferred. Strong executive-level presentation and communication skills are also required.

Position Purpose: Direct and oversee health insurance operations programs in multiple service areas focused on Duals including as billing and enrollment, call center, customer service, etc. and related initiatives that impact membership for product lines and health plans. Manage service levels; identify service opportunities, new business implementations and product expansions. Responsible for multiple systems from a business owner standpoint for all membership and channel management services.

• Direct the identification, development, and implementation programs centered on quality and operations excellence for Medicare Duals programs
• Develop and monitor service levels to ensure compliance with state, federal, and company metrics and standards
• Initiate ongoing and special projects including process improvement evaluations and analysis, department business development, ROI analysis, and annual satisfaction initiatives
• Direct all membership related initiatives including identification of business need, strategy recommendation, project outline, management of deliverables, and ROI
• Work collaboratively to facilitate the design, development and implementation of policies, procedures and practices related to service operations
• Establish and maintain working relationships with external sources such as CMS for regulatory and compliance guidance
• Develop and maintain collaborative relationships with health plans, other business units, IT partners, and oversee training and business processes as necessary
• Direct and oversee continuous improvement of multiple systems for critical operations to enable business objectives

Education/Experience:

• Bachelor’s degree in business or related field or equivalent experience.
• 10+ years of business operations and systems integration experience for call centers, enrollment, billing, payment processing, or similar operations applications.
• Previous management experience includes responsibilities for hiring, training, assigning work and managing performance of staff.
• Health insurance and program management preferred.
• Extensive experience with Medicare and Medicaid operations, with Duals program experience highly preferred.
• Strong executive-level presentation and communication skills are also required

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