Centene Corporation Behavioral Health Director, Claims Operations in Rancho Cordova, California

ProfessionalPosition Purpose:

Develop the vision and goals for the claims department in compliance with federal, state and Company guidelines

Oversee and ensure achievement and maintenance of all claims processing standards within established guidelines

Partner with multiple business units, health plans and other stakeholders to establish operational objectives and procedures.

Identify business needs and drive change initiatives to address these issues

Ensure all issues are resolved accurately and timely and implement action plans to address any issues

Identify and implement operational efficiencies and development of “best practice” policies and procedures

Analyze customer impact and respond to complex escalated customer service and claims processing issues to ensure that customer expectations are consistently metDirect the day-to-day operations of the claims department and ensure accurate and timely processing of members medical claims within established state and company compliance guidelines.


Bachelor’s degree or equivalent experience. 7+ years of operations management, financial management or analysis, or claims operations experience, preferably in a managed care and/or Medicaid setting. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

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.

TITLE: Behavioral Health Director, Claims Operations

LOCATION: Rancho Cordova, California

REQNUMBER: 1107175

COMPANY: Claims Operations, Leadership

POSITION TYPE: Professional