United States onlyYou could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Under direct supervision, the Operations Analyst II researches and analyzes enrollment data and/or business processes to develop and implement process improvements while acquiring a more advanced skill set for designing and implementing strategic solutions. Interfaces with internal associates and external resources, including Subcontractors and Government entities, to gather information and implement solutions. Participates in projects to identify and document business requirements, implement new technology, research and resolve business issues, and plan and develop systems implementation tactics, including project and test plan input.
- Gathers, evaluates, interprets, and analyzes data and business processes, or develops test scenarios to evaluate system defects.
- Presents information, recommendations and alternatives to facilitate management understanding of results and impact.
- Produces reports or file extracts for data analysis.
- Evaluates Enrollment department policies and procedures and recommends changes to improve the overall productivity and quality of department systems.
- Identifies opportunities to improve system processes and recommend changes to streamline operations and/or automate manual processes.
- At times, may assume responsibility for data integrity among various internal groups and/or between internal and external sources.
- Participates in projects that contribute to achievement of department objectives.
- Projects will be completed on-time, within budget, and according to established objectives and documented requirements.
- Participates in developing project plans, test plans, implementation strategies, and post implementation plans.
- Provides business function support for system upgrades and Government-mandated change orders.
- Prepares status reports and/or issue resolution to internal associates and/or external resources.
- Participates in developing and reviewing business system requirements and scope and design documents.
- Troubleshoots user-reported system defects and educates users on issues that are not true-system defects.
- Analyzes true defects and follows up with applicable subcontractor to resolve.
- Performs other duties as assigned.
- Complies with all policies and standards.
Education/Experience: High School Diploma or equivalent. Experience in researching and analyzing data for the purpose of process improvement is preferred. Two years health plan or health insurance operations experience, including participating on project teams. Experience in Enrollment, billing and/or claims processing preferred. Prefer candidates with a process improvement or project management background who have skills using SQL, Excel, Powerbi, and Smartsheet.
Pay Range: $55,100.00 - $99,000.00 per yearCentene 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. Total compensation may also include additional forms of incentives.
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
