Vice President II, Configuration Operations

Centene is transforming the health of our communities one person at a time.  As an Executive on our team, you could be the one who changes everything for our 28 million members.
 

Position Purpose:

Provides enterprise leadership and strategic oversight for benefit and provider payment configuration that supports accurate claims adjudication, benefit administration, and provider pricing across Medicare, Medicaid, and Marketplace lines of business and multiple platforms. This role ensures claims configuration, authorization and payment requirements, benefit rules, pricing logic, and system alignment collectively enable compliant, efficient, and scalable claims processing.

Aligns operational execution with regulatory requirements, financial integrity, and enterprise strategy. The position is accountable for driving configuration excellence, ensuring system readiness to support evolving regulatory and business needs, and enabling operational performance that supports accurate, timely, and compliant claims outcomes.

• Establish and execute the enterprise strategy for claims configuration operations, including benefit configuration, authorization payment logic, and provider pricing.

• Serve as the accountable business owner for claims configuration platforms and pricing systems.

• Ensure configuration complies with CMS, state Medicaid agencies, Marketplace requirements, and contractual obligations.

• Drive continuous improvement to reduce claims payment errors and rework.

• Lead and develop high-performing configuration operations teams.

• Performs other duties as assigned.

• Complies with all policies and standards.

Education/Experience:

• Bachelor's Degree in Business Administration, Healthcare Administration, Information Systems or related field required.

• Master's Degree preferred.

• 10+ years of progressive leadership experience in healthcare, managed care, or health insurance operations including claims adjudication systems, benefit configuration, and provider pricing required.

• Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Pay Range: $227,700.00 - $431,400.00 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