Director, Claims Configuration

Centene Corporation

. Oversee claims configuration and pricing/benefits setup within the claims payment system .

Posted 9/15/2026full-timeRemote • Michigan • United StatesLead💰 $141,500 - $261,400 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in claims configuration, pricing and benefits setup, and claims adjudication, ensuring accurate provider contract reflection and timely implementations. Strong collaboration skills are essential for gathering business requirements and facilitating smooth transitions into claims systems.

Highest-signal resume keywords

Claims ConfigurationPricing/Benefits SetupClaims AdjudicationContracting ExperienceBusiness Requirements Gathering

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ConfigurationPricing SetupBenefits SetupClaims AdjudicationContract ManagementProcess AutomationData AnalysisImplementation EvaluationSystem ConfigurationProvider Contract Management

Soft Skills

CollaborationStakeholder EngagementCommunicationProblem-SolvingAttention to Detail

Industry Keywords

Health Care AdministrationBusiness AdministrationInformation TechnologyClaims Payment SystemProvider Contracts

About the role

Key responsibilities & impact

Oversee claims configuration and pricing/benefits setup within the claims payment system
Ensure accurate reflection of provider contracts and claims payments
Ensure timely and accurate configurations and pricing/benefits setup 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 setup
Identify and implement opportunities to automate processes
Oversee evaluation and analysis of upcoming implementations
Ensure successful and smooth transition into claims systems and processes

Requirements

What you’ll need

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
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

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
Stock purchase plan
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