Broker Program Integrity Manager

Posted:
10/15/2024, 5:00:00 PM

Location(s):
Texas, United States ⋅ Florida, United States ⋅ Emilia-Romagna, Italy

Experience Level(s):
Senior

Field(s):
Product

Workplace Type:
Hybrid

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.
 

Position Purpose: Manages Broker Oversight program and relationships with Broker/Agency partners for compliance performance management standards, program education and delivery, and proactively implements appropriate business solutions as required. Acts as the critical link between our agency partners and internal Departments regarding broker behavior and compliance to policies and procedures.
  • Provide direct complaint oversight responsibilities with agency/broker partners including identification, monitoring and education. Scheduling regular meetings, agenda management, documentation and minutes.

  • Provide and share monthly SLA performance dashboards, reporting, and policies and procedures with broker/agency partners and address any issues in performance of assigned SLA’s. Build monthly summary reports, including action and education plans.

  • Maintains regular communications with agency leads and has the ability to lead and deliver difficult conversations regarding the misappropriation of broker conduct.

  • Directs, monitors and/or contributes to special projects and other planning initiatives that are highly complex and involve complaint oversight.

  • Health Plan liaison regarding broker complaints, obtaining data for cases, presenting with Health Plans to DOI, and other government entities about broker fraud activity.

  • Ability to work with large data sets, high proficiency in Excel, Power BI, and creating PowerPoint presentations.
  • Performs other duties as assigned

  • Complies with all policies and standards

Education/Experience: Bachelor's Degree Business Administration, Public Administration or related field or equivalent experience required
5+ years experience supporting and working with Primary Care Providers, Account Management within Healthcare or related field required
Ability to present to executive-level teams required

Pay Range: $84,300.00 - $151,700.00 per year

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.

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