Product Operations Specialist

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: This position supports the implementation and/or drives the ongoing operational maintenance of assigned product(s) or service area(s) through communication and solid relationship management with internal and external stakeholders, identifying opportunities for integrated process improvement, escalating issues as necessary, and supporting the success of the product. Creates and maintains reporting tools to effectively analyze and develop process improvement opportunities that enhance the operational effectiveness of the product(s) or service area(s).

Essential Functions:

• Serves as the subject matter expert (SME) for the assigned product(s) or service area(s).
• Drives assigned operational aspects of the product(s)/service(s).
• Assesses operational performance and escalations by tracking, analyzing and researching performance level expectations.
• Monitors assigned internal/external relationships to ensure compliance with contractual requirements.
• Develops effective relationships with key partners and stakeholders to influence and drive operational enhancements.
• Proactively identifies trends and root cause analysis to drive resolution of complex escalations; including communications and reporting.
• Creates reports and supports business review presentations to key stakeholders; including, but not limited to, Senior Leadership Team, Vendors and/or Government agencies.
• Participates in and supports department and/or product strategic planning

activities.

• Manages projects including the implementations for delegated functions as needed.
• Collaborates with internal and/or external partners to execute assigned business objectives and initiatives.
• Ensures member or other stakeholder communications contain appropriate information, talking points and FAQs, and are effectively implemented.
• Performs other duties as assigned.

Education/Experience: Required A Bachelor's Degree in business administration / related field or equivalent work experience. Required 2+ years of experience in Leading or supporting projects in the following areas: Benefits, Product Management, Marketing and Sales, Strategic Planning, and/or Project Management.

–OR-

Data analysis and process improvement in the following areas: Benefits, Healthcare or Regulatory/Government Affairs.

-OR-

Vendor management or oversight; preferably with healthcare vendors
Required 2+ years of experience in customer service experience in a healthcare contact center or customer service environment dealing with claims, grievances pharmacy and appeals authorizations in one or more of the following: Medicare, Medicaid, PDP, Exchange etc. Preferred Other Experience in health care or managed care environment. Preferred Other Experience working the state reporting, regulatory/government affairs.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.