Director, Claims Business Implementation

Centene Corporation

. Oversee implementation of products and plans into Claims business units .

Posted 9/17/2026full-timeRemote • Missouri • United StatesLead💰 $148,000 - $274,200 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive project management expertise with a focus on claims business implementations, ensuring alignment with strategic goals and adherence to standard processes. Possesses strong leadership capabilities in managing operations within Government Programs Managed Care, particularly in Claims and Provider Services.

Highest-signal resume keywords

Project ManagementClaims Business ImplementationGovernment Programs Managed CareOperational OversightBusiness Requirements Documentation

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Project Management MethodologiesClaims Operations ManagementImplementation ProcessesPerformance Metrics DevelopmentBudget Management

Soft Skills

Strategic LeadershipCollaborationCommunication

Industry Keywords

Medicaid Managed CareHealth Plan Business ImplementationClaims Process OwnerProvider ServicesMedical Management

About the role

Key responsibilities & impact

Oversee implementation of products and plans into Claims business units
Ensure alignment with strategies and goals and consistency in implementation processes, methodology, and models
Direct creation and maintenance of standard models for the claims implementation approach
Manage all Claims and Configuration Operations functions during the implementation phase
Provide strategic leadership and oversight of claims business implementation processes
Manage adherence to standard implementation processes and collaborate on Business Requirements Document approvals with the Claims Process Owner
Provide input into operating models, corporate functional and information system models, performance metrics, expected outcomes, and plan impacts
Direct claims business implementations to meet budget, timeline, and scope requirements
Provide input into business planning and develop timelines for New Health Plan Business Implementations

Requirements

What you’ll need

Bachelor's degree in related field or equivalent experience
Master's degree preferred
7+ years of project management experience
Detailed understanding and experience applying project management methodologies and tools
5+ years of Government Programs Managed Care experience in multiple areas of Operations, including Claims, Provider/Mbr Services, Medical Management, or Network
Medicaid Managed Care experience preferred

Benefits

Comp & perks

Health insurance
401K plan
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation
Equal opportunity employer committed to diversity