Director, Payment Integrity - Appeals & Disputes
Centene Corporation Morocco
Looking for a Remote AI role? Director, Payment Integrity - Appeals & Disputes at Centene Corporation is listed on Makely Remote Jobs as a Part-time opening based in Morocco (Worldwide). Review the role overview below, then apply on the employer’s original listing — Makely Remote Jobs does not process applications.
Skills
- Payment Integrity
- Healthcare Compliance
- Claims Management
- Healthcare Finance
- Director Of Healthcare Operations
- Payment Integrity Director
- Director Of Payment Risk
- Director Of Payment Operations
- Senior Director Healthcare Payment Operations
- Director Of Payments
- Payment Integrity Leadership
Role overview
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: Oversee prepay waste and abuse reviews through coding, editing, and audit programs. Provide guidance and set policies to ensure all programs adhere to state and federal regulations as well as company policies.
- Oversee prepay editing and retrospective audits to ensure accurate and timely payments of coding and pricing issues
- Interpret audit results, develop action plans and present findings to senior management
- Develop and implement continuous processes from analytic design to final report stage
- Design, develop, and implement internal payment integrity edit and audit programs, policies, and procedures
- Monitor laws and regulations that may impact payment integrity policies and procedures and implement changes while maintaining compliance with all state and federal regulations
- Recommend process improvement to assist in developing and executing strategic initiatives and goals
- Develop and deliver educational training programs to providers and employees to streamline operational processes and ensure accurate coding
- Direct and lead Prepay Compliance Managers in their efforts to reduce waste, abuse, and fraud
- Performs other duties as assigned
- Complies with all policies and standards
Compliance/ERM: 7+ years experience preferredPay Range: $107,700.00 - $199,300.00 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
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
Originally posted on Himalayas
Summary provided for discovery. Always confirm details and apply on the original source. Makely Remote Jobs is not the employer and does not process applications.
Frequently asked questions
Is Director, Payment Integrity - Appeals & Disputes at Centene Corporation a remote job?
Yes. This listing is categorized as Remote on Makely Remote Jobs. Confirm any location or timezone limits in the original posting before you apply.
What is the employment type for Director, Payment Integrity - Appeals & Disputes?
Source data lists this as Part-time. Always verify the contract type, benefits, and start date on the employer’s application page.
Where is Director, Payment Integrity - Appeals & Disputes located?
Listed location: Morocco. Many remote AI roles allow work-from-home with country or timezone restrictions — check the full description.
Do I apply on Makely Remote Jobs?
No. Makely Remote Jobs aggregates public remote job feeds for discovery. Use “Apply on Original Site” to open the employer’s official application URL. We never host applications or collect resumes.
What is the salary for Director, Payment Integrity - Appeals & Disputes?
Reported pay range: USD 107,700 – USD 199,300 / year. Figures come from the source feed when available and may be incomplete — confirm compensation during the application process.