Payment Integrity Business Partner II

Centene Corporation

. Serve as the primary point of contact for assigned health plans, markets, and stakeholders regarding Payment Integrity programs, initiatives, and issue resolution .

Posted 10/23/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Payment Integrity, healthcare operations, and vendor management while effectively collaborating with cross-functional teams to enhance operational performance and stakeholder experience. Proficient in analyzing performance metrics and communicating insights to leadership and business partners.

Highest-signal resume keywords

Payment IntegrityHealthcare OperationsVendor ManagementPerformance Metrics AnalysisPMP Certification

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims OperationsHealthcare ReimbursementMedicareMedicaidMarketplace OperationsOperational EffectivenessRevenue EnhancementComplianceAuditProcess Improvement

Soft Skills

Relationship BuildingInfluencing StakeholdersCommunicationProblem SolvingCollaboration

Certifications & Qualifications

PMPLean Six Sigma

Industry Keywords

Payment Integrity ProgramsManaged CareProvider RelationsOperational StandardsRegulatory Compliance

Tech Stack

Tools & technologies

PMP

About the role

Key responsibilities & impact

Serve as the primary point of contact for assigned health plans, markets, and stakeholders regarding Payment Integrity programs, initiatives, and issue resolution
Build and maintain working relationships with market leadership, providers, vendors, and internal business partners
Represent Payment Integrity in meetings, workgroups, governance forums, and strategic initiatives
Communicate program performance, savings opportunities, operational impacts, trends, and policy updates
Support implementation of Payment Integrity initiatives and coordinate activities across operational, clinical, coding, analytics, compliance, regulatory, and vendor teams
Manage assigned vendor relationships and monitor performance
Support revenue-enhancement and operational improvement initiatives
Facilitate resolution of stakeholder, provider, regulatory, vendor, and operational issues
Analyze performance metrics and identify opportunities to improve payment accuracy, operational effectiveness, and stakeholder experience
Document decisions, themes, risks, and follow-up actions
Perform other duties as assigned
Comply with all policies and standards

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 and 2–4 years of related experience, or equivalent experience acquired through applicable knowledge, duties, scope and skill
3+ years of experience in healthcare operations, managed care, claims, payment integrity, provider relations, vendor management, or a related field
Experience collaborating with and influencing cross-functional teams and business stakeholders
Experience presenting information, updates, and recommendations to leadership or business partners
Experience in Payment Integrity, claims operations, healthcare reimbursement, Medicare, Medicaid, Marketplace, or managed care operations preferred
Experience managing vendors, outsourced services, or external business partners preferred
Experience supporting provider, regulatory, compliance, audit, or revenue-enhancement activities preferred
Experience interpreting operational, financial, or performance data preferred
PMP and/or Lean Six Sigma certification and related project, process improvement, or operational excellence experience strongly preferred

Benefits

Comp & perks

Competitive pay
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