Centene Corporation logo

Vice President, Claims Configuration Operations (Health Plan)

Job Overview

Location

Remote-NJ

Job Type

Full-time

Category

Operations

Date Posted

May 10, 2026

Full Job Description

đź“‹ Description

  • • Oversee business operations, procurement opportunities, new product implementations, and complex initiatives for business development utilizing cross-functional business units and corporate teams to meet strategic objectives.
  • • Partner with stakeholders and leadership to establish strategic visions, operational objectives, and policies ensuring compliance with state contracts, laws, regulations, and executive orders.
  • • Monitor and report achievement of committed action plans to senior management.
  • • Direct the development and implementation of operational work processes and systems with oversight for multiple departments within the business unit.
  • • Accountable for budget, revenue targets, and Profit & Loss.
  • • Lead and oversee new business implementation and procurement activities for all products and complex projects, including RFP responses.
  • • Evaluate program opportunities and recommendations for effectiveness and ROI.
  • • Perform duties as senior liaison between the business unit, corporate, and external stakeholders.
  • • Oversee preliminary discovery, due diligence for potential liabilities, internal control weaknesses, and financial integrity.
  • • Establish and maintain operational strategic vision for specialty operations, including pharmacy fulfillment and case management.

🎯 Requirements

  • • Bachelor’s Degree in Business Administration, Finance, Accountancy, or a related field required.
  • • 9+ years of operations, management, or administration experience in the Healthcare or Insurance industry required.
  • • Experience in business development and/or Request for Proposal (RFP) preferred.
  • • Master’s Degree preferred.
  • • Extensive knowledge of state legislative and regulatory processes preferred.
  • • For Acaria Health Specialty Pharmacy, substitution of a PharmD coupled with 9+ years of experience is acceptable.

🏖️ Benefits

  • • Competitive pay within the range of $171,900.00 - $326,900.00 per year.
  • • Comprehensive benefits package including health insurance, 401K, and stock purchase plans.
  • • Tuition reimbursement and paid time off plus holidays.
  • • Flexible work arrangements with remote, hybrid, field, or office schedules.
  • • Additional forms of incentives may be included in total compensation.

Skills & Technologies

Remote
Degree Required

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Centene Corporation logo
Centene Corporation
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About Centene Corporation

Centene Corporation is a publicly traded managed-care enterprise that arranges health-benefit programs for government-sponsored and privately insured individuals. Operating across all 50 U.S. states and internationally, the company focuses on under-insured and uninsured populations through Medicaid, Medicare, and Marketplace offerings. Its services include behavioral health, pharmacy benefits, vision, dental, telehealth, and in-house clinical programs. Centene partners with physicians, hospitals, and community organizations to coordinate cost-effective care, emphasizing data analytics and value-based reimbursement models. Headquartered in St. Louis, Missouri, it serves more than 25 million members, positioning itself as a leading intermediary between payers and healthcare providers.

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