Senior Manager, Medical Loss Ratio

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.
 

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.

• Bachelor's Degree in Finance, Accounting, Actuarial Science, Business, Healthcare Administration, Public Health, or a related field; or equivalent experience required
• Juris Doctor (JD) preferred
• Master's Degree preferred
• 4+ years healthcare finance, managed care operations or related experience required
• Experience interpreting and applying federal and state MLR guidance, including use of judgment to resolve complex classification and methodology questions and translate requirements into scalable processes and controls required
• Experience providing oversight and final review of complex analyses (e.g., reconciliations, variance/root-cause analysis) and ensuring documentation quality appropriate for audits and regulatory submissions required
• Experience communicating with and influencing senior leaders and cross-functional stakeholders, including escalating risks/issues and presenting clear recommendations and decision points required
• Advanced experience with Excel and reporting/analytics tools required
• Experience with health plan finance/claims systems and data warehouses preferred

• CPA, CMA, CIA, or other relevant accounting/audit credential preferred
• CHC, CRC or other healthcare compliance certification preferred

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