Director, Claims Configuration

Position Purpose

Oversee the claims configuration and pricing/benefits set up within the claims payment system ensuring accurate reflection of provider contracts and claims payments.

Key Details

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

• Ensures timely and accurate configurations and pricing/benefits set up for new business implementations
• Ensure changes in provider contracts are reflected in the claims payment system
• Collaborate with stakeholders to gather business requirements for system configurations and set up
• Identify and implement opportunities to automate processes to increase effectiveness and efficiency
• Oversee the evaluation and analysis of upcoming implementations and ensure successful and smooth transition into claims systems and processes

Education/Experience

Bachelor's degree in Business Administration, Health Care Administration, Information Technology or related field or equivalent experience. 7+ years of configuration, claims adjudication, pricing/benefits setup, or contracting experience.Pay Range: $141,500.00 - $261,400.00 per year At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

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 remo