Jobs
>
St. Louis

    Regional Vice President, Claims Operations - St. Louis, United States - Centene Corporation

    Centene Corporation
    Centene Corporation St. Louis, United States

    6 days ago

    Default job background
    Full time
    Description

    Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.

    Position Purpose: Lead a large scale organization accountable for the accurate, timely and efficient processing of Claims. Set the strategic vision and objectives of the claims operations to drive innovation, higher operational performance and quality outcomes.

  • Set the strategic claims vision in compliance with federal, state and Company guidelines
  • Leverage industry best practices, technology innovations and process redesign elements into the strategic vision of claims to support the continued organic and inorganic growth of the company.
  • Direct day to day operations of the claims departments and ensure the claims are processed within established government and company guidelines.
  • Empower the claims leadership team and supports the department and ensure quality claims metrics and service level agreements are met
  • Collaborate with executive leadership from internal departments to ensure efficiency and proper prioritization of the claims adjudication process
  • Develop production and quality standards are met and stretch goals are established to drive sustainable long-term quality and efficiency models
  • Set service levels and increase real time prioritization and productivity capabilities
  • Drive innovation to Establish, evaluate, and implement processes and procedures to accomplish the organization's and departments' objectives
  • Ensure compliance with all state and federal claims payment laws and guidelines

    • Education/Experience:

    Bachelor's degree in Business Administration, Management, or Finance; Master's degree preferred. 10 years of experience in overseeing and developing claims operations, preferably in a managed care and/or Medicaid setting. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

    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. Total compensation may also include additional forms of incentives.

  • Cigna

    Claim Operations Analyst

    3 weeks ago

    Cigna St Louis, United States

    Position Summary · Evernorth Accountable Care is a new business focused on partnering with healthcare providers to form value-based care relationships, improving care for patients, and reducing total healthcare costs. Evernorth Accountable Care will be delegated select claims pr ...

  • The Cigna Group

    Claim Operations Analyst

    4 weeks ago

    The Cigna Group St. Louis, United States OTHER

    The job profile for this position is Operations Lead Analyst, which is a Band 3 Senior Contributor Career Track Role.Excited to grow your career? · We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting ne ...

  • Panera Bread

    Analyst ll, Workers Compensation

    5 days ago

    Panera Bread St. Louis, United States Full time

    Analyst ll, Workers Compensation The Analyst, Workers' Compensation will own the management of all Workers' Comp claims for the organization from inception through resolution while learning and understanding the corporate process. Preferably the position will be based out of the ...

  • TEKsystems

    Program Coordinator

    3 weeks ago

    TEKsystems St. Louis, United States Contract

    Hiring For Program Coordinator Role · 100% Remote Role · Note: Candidates from Missouri location can only apply · Description: · 2-3 years medical csr or physician's office experience. Thorough knowledge of customer service, utilization review or claims processing practices in a ...

  • Accounting Career Consultants, ACC Legal & HR Career Consultants

    Benefits and Employee Engagement Manager

    6 days ago

    Accounting Career Consultants, ACC Legal & HR Career Consultants St. Louis, United States

    Why is This a Great Opportunity? · Growing organization with a great HR team. · Job Description: · We are seeking a dynamic and detail-oriented Benefits/Employee Engagement Manager for a client of ours in St. Louis. The ideal candidate will be responsible for overseeing various a ...

  • Allied Universal

    Surveillance Investigator

    3 weeks ago

    Allied Universal St. Louis, United States Part time

    Job Description · Allied Universal is hiring a Surveillance Investigator. Surveillance Investigators perform discreet mobile and stationary surveillance of Claimant to confirm current activities and capabilities to assist with the administration of an Insurance claim. · Remote wo ...

  • BJC HealthCare

    Patient Accounts Analyst

    3 weeks ago

    BJC HealthCare St. Louis, United States Full time

    Job Description · Additional Information About the Role Do you have experience with insurance denials? BJC is looking for a Patient Accounts Analyst Remote Position Monday - Friday Flex Schedule Overview BJC HealthCare is one of the largest nonprofit health care organizations in ...

  • Enterprise Bank & Trust

    Debit Card Fraud Analyst

    2 weeks ago

    Enterprise Bank & Trust St. Louis, United States Full time

    Enterprise Bank & Trust was founded in the spirit of entrepreneurship and community. From the small mom-and-pop coffee shop to the large construction company that employs local people, our goal is to help businesses succeed and our communities thrive. · With offices in Arizona, ...

  • The Cigna Group

    Coverage Review Operations

    1 week ago

    The Cigna Group St. Louis, United States Full time

    Coverage Review Operations provides a variety of clinical services that help health plans and pharmacy benefit managers protect patient health and safety and improve affordability while reducing unnecessary costs. The Director is responsible for the daily oversight and management ...

  • Zelis

    Client Support Specialist

    2 weeks ago

    Zelis St. Louis, United States Full time

    Position Overview · The Client Support Specialist (CSS) serves as the primary point of contact for multiple Zelis Clients post Go-Live for processing of Claims Communications, Payments, and/or ID cards. The CSS is responsible forassisting the client with the successful processing ...

  • Elevance Health

    Data Analytics/Data Science Analyst

    3 weeks ago

    Elevance Health St. Louis, United States Full time

    Job Description · : Data Analytics/Data Science Analyst · Location: This position will work a hybrid model (remote and office). An ideal candidate must live within 50 miles of one of our Elevance Health PulsePoint locations listed here: Chicago, IL; Indianapolis, IN; St. Loui ...

  • Lockton Companies

    Account Executive-Casualty

    1 week ago

    Lockton Companies St. Louis, United States Full time

    Overview: · Lockton Midwest is looking for a Casualty Account Executive to join our Risk Management Practice. In this role, you will be a key member of a growing team working together in client servicing, retention, and growth while delivering risk management solutions that posit ...

  • Motion Recruitment

    Financial Paralegal Analyst

    4 days ago

    Motion Recruitment St. Louis, United States Contract

    Outstanding long-term contract opportunity A well-known Financial Services Company is looking for a Business Execution Administrator in Saint Louis, MO (Hybrid). · Work with the brightest minds at one of the largest financial institutions in the world. This is long-term contract ...

  • Hub International

    Account Administrator, Employee Benefits

    2 weeks ago

    Hub International St. Louis, United States

    Primary Role: · As an Employee Benefits Account Administrator, you will be responsible for assisting Account Managers, Account Executives and Risk Consultants with the servicing and administration of assigned accounts in accordance with the practices, policies, and procedures of ...

  • TEKsystems

    Healthcare Customer Service Specialist

    1 week ago

    TEKsystems St. Louis, United States Contract

    Customer Service Specialists are responsible for learning and understanding the entire front-end process to ensure successful service for our patients. The Customer Service Specialists works in a fast-paced environment answering inbound calls and making outbound calls. May be res ...

  • St. Louis Housing Authority

    Assistant Property Manager

    1 week ago

    St. Louis Housing Authority St. Louis, United States

    POSITION SUMMARY: · This is an exempt position under the general direction of the Property Manager, who plans, organizes, coordinates, and implements the daily operation of public housing developments within the St. Louis Housing Authority's (SLHA) portfolio. The Assistant Proper ...

  • Bernhard

    Commissioning Agent I

    3 weeks ago

    Bernhard St Louis, United States

    Bernhard's core mission is delivering innovative engineering, construction, and energy solutions that empower our clients and promote a sustainable future. Bernhard is comprised of four divisions: Mechanical, Electrical, Engineering, and Development, each with a distinct identity ...

  • SSM Health

    Director Enterprise

    1 week ago

    SSM Health St. Louis, United States

    Internal Number: R136852 · PRIMARY RESPONSIBILITIES · Oversees various aspects, including claims management, of a complex and growing insurance portfolio, which includes, but is not limited to, the following programs: Professional Liability/Medical Malpractice, General Liability, ...

  • Stifel

    Deputy General Counsel

    3 weeks ago

    Stifel St. Louis, United States Full time

    Summary · The Deputy General Counsel will provide legal advice and service primarily to Stifel Financial Corp.'s subsidiary banks and trust companies (collectively, the "Banks"). In cooperation with management of the Banks and their parent company, the candidate will have respons ...

  • Copeland

    Director, Global Benefits

    2 days ago

    Copeland St. Louis, United States

    If you are a BENEFITS professional looking for an opportunity to grow, Copeland has an exciting opportunity for you As the Director of Global Benefits , you will be a strategic leader responsible for developing and executing a comprehensive benefits strategy that aligns with ou ...