Program Manager III - Provider Data Operations

Position Purpose: Promote increased program efficiency, service levels, and value by capturing and monitoring performance, and then identifying opportunities for improvement and strategies to realize those opportunities. Plan, organize, monitor, oversee and lead multiple, concurrent resultant projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

Key Details: The Program Manager III leads the planning, execution, governance, and delivery of complex Mission Simplify initiatives supporting Provider Data Operations transformation. Partnering across business, technology, domain, and operational teams, this role drives initiatives from discovery through implementation and operational transition. The ideal candidate is a strategic, influential leader who aligns stakeholders, mitigates risk, and delivers measurable improvements in efficiency, provider data accuracy, and enterprise consistency through process optimization, automation, operating model transformation, and technology enablement.

• Identify opportunities to increase efficiency, improve service levels, ensure regulatory compliance, and support successful implementation of Mission Simplify initiatives through enhanced operations.

• Develop strategies to realize improvement opportunities and ensure organizational prioritization, resource alignment, and achievement of strategic business objectives.

• Manage multiple projects through the full project lifecycle, including discovery, requirements gathering, scope definition, project planning, resource management, budget oversight, implementation, deployment, and transition activities.

• Utilize corporate and industry-standard project management tools and techniques to develop integrated project plans, milestones, dependencies, RAID logs, and executive status reporting.

• Maintain detailed project documentation, including action items, issues logs, risk mitigation plans, business requirements, acceptance criteria, and testing readiness documentation.

• Provide leadership and effectively communicate project status to all stakeholders through executive summaries, dashboards, presentations, and governance updates.

• Negotiate with project stakeholders to identify and secure resources, resolve issues, mitigate risks, and ensure stakeholder alignment and formal scope sign-off.

• Lead cross-functional meetings and governance routines with Business Analysts, SMEs, technology teams, operational leaders, and business partners to meet stakeholder expectations and organizational objectives.

• Provide functional and technical knowledge regarding overall program requirements, operational processes, and business solution implementation.

• Monitor project health, track key performance indicators, identify risks and issues, and develop mitigation plans to ensure business benefits and value realization objectives are achieved.

• Support change management, training readiness, stakeholder communications, and operational transition activities to promote successful adoption and implementation.

• Establish and promote project management standards, tools, templates, and best practices while managing multiple concurrent initiatives with varying levels of complexity and organizational impact.

Education/Experience:

• Bachelor’s degree in Business Administration, Healthcare Administration, related field, or equivalent experience.

• Master’s degree preferred.

• 5+ years project implementation, product or program management experience.

• Managed care or prescription benefit management experience preferred.

Preferred Qualifications:

• Healthcare payer, provider operations, provider data management, network operations, or health plan experience.

• Proficiency with project management and reporting tools such as Smartsheet, Jira, Power BI, Microsoft Office Suite, and collaboration platforms.

• PMP, PgMP, Lean Six Sigma, Agile, Scrum, or related certification.

• Experience leading process improvement, automation, digital transformation, or operating model redesign initiatives.

• Knowledge of provider credentialing, provider data management, enrollment operations, network management, or healthcare operations.

• Experience supporting large-scale strategic transformation programs with measurable operational and financial outcomes including presenting to senior leadership and influencing decision-making across multiple business functions.

• Experience leading enterprise-wide and cross-functional initiatives with multiple stakeholders.

• Demonstrated experience managing project plans, requirements, risks, dependencies, budgets, and executive communications.

• Experience facilitating requirements workshops, stakeholder engagement sessions, and governance reviews.

• Knowledge of project management methodologies and delivery frameworks.

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
 

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