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.
Remote Available.
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.
Position Purpose: Responsible for analytical data needs. Handle complex data requests, reports, and predictive data modeling. This Internal Audit Claims role supports claims data analysis, recurring audit sampling and reporting, data validation and reconciliation, Power BI dashboard support, executive-ready reporting, and process improvement.
Key Duties and Responsibilities:
Analyze health management and Internal Audit Claims programs, including data collection, validation, reconciliation, outcome measurement, and trend analysis.
Analyze claims, provider, member, financial, operational, and audit-related data used to support recurring reporting and audits.
Extract, transform, reconcile, and validate data using SQL, advanced Excel, Power BI, and enterprise data sources.
Create and maintain reports and dashboards, including data connections, transformations, refresh validation, presentation quality, and supporting documentation.
Produce reports for and interface with senior management and internal and external stakeholders.
Gather and interpret business requirements, monitor data trends, identify issues, and communicate findings and risks clearly.
Support recurring claims sampling, sample-upload, reporting, and data-quality activities, including validation of inputs and outputs and documentation of identified differences.
Handle multiple projects and timelines effectively and communicate risks and issues to the manager regularly.
Support ETL, reporting automation, and other process-improvement efforts through requirements gathering, testing, output validation, and documentation.
Assist with training and cross-training on recurring data analytics and reporting processes.
Assist with training lower level Data Analysts
Performs other duties as assigned.
Complies with all policies and standards.
Education/Experience:
Bachelor’s degree’s related field or equivalent experience. 2+ years of statistical analysis or data analysis experience.
Preferred Skills:
Hands-on SQL experience, including extracting, joining, transforming, reconciling, and validating data.
Power BI experience, including dashboard development, data connections, Power BI Desktop and Service, refresh validation, and report or workspace maintenance.
Advanced Excel skills and experience producing accurate, executive-ready PowerPoint and reporting deliverables.
Experience with ETL processes and enterprise data environments such as Snowflake, Teradata, MS SQL Server, EDW, or similar platforms.
Healthcare claims analytics, audit, compliance, quality, or regulatory reporting experience strongly preferred.
Strong attention to detail, data-reconciliation discipline, and ability to translate technical findings into concise management-ready explanations.
Exposure to descriptive or inferential statistical methods preferred.
By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.
Pay Range: $56,200.00 - $101,000.00 per yearCentene 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
