Top 4978 Plan manager Jobs in Alabama

Manager, Payment Integrity-COB/TPL /Subrogation
Centene —Alabama
- $87,700 - $157,800 a year
- Full-time
- Remote
- Management
- Mid-level
- Supervising experience
- Paid holidays
- Health insurance
3d
Manager, Project Mgt (IC)
CVS Health —Alabama
- $54,300 - $159,120 a year
- Full-time
- Remote
- Microsoft Excel
- 3 years
- Bachelor's degree
- Health insurance
- Dental insurance
Area Process Manager - Paper
International Paper —Prattville, AL
- $130,000 - $180,000 a year
- Full-time
- 5 years
- Engineering
- Organizational skills
Sr. Manager, Forecasting & Business Planning
CVS Health —Alabama
- $67,900 - $199,144 a year
- Full-time
- Remote
- Bachelor's degree
- Fair chance
- Experience equivalent to degree accepted
- Health insurance
- Dental insurance
12h
Production Center Manager - Title Operations (Remote)
First American Title Insurance Co —Alabama
- $85,000 - $113,300 a year
- Full-time
- Remote
- Customer service
- Databases
- Bachelor's degree
- Employee stock purchase plan
- Health insurance
Quick Apply
8d
PROGRAM MANAGER II
University of Alabama at Birmingham —Birmingham, AL
- $51,270 - $83,300 a year
- Day shift
- Management
- 5 years
- Research
Supervisory Program Manager (Division Administrator)- Direct Hire
US Federal Motor Carrier Safety Administration —Montgomery, AL
- $125,776 - $187,093 a year
- Online Application
- Hybrid work
- Background check
- Pass drug screening
- Office
9d
Sr Manager, Operations - AMZ8004.12
Amazon.com Services LLC - A57 —Theodore, AL
- $135,000 - $182,700 a year
- Full-time
- Master's degree
- Mentoring
- Recruiting
Area Process Manager - Woodyard
International Paper —Prattville, AL
- $101,000 - $148,100 a year
- Full-time
- Engineering
- 3 years
- Organizational skills
PBM Call Center Manager - Remote US
Gainwell Technologies —Alabama
- $87,300 - $124,700 a year
- Full-time
- Remote
- HIPAA
- 3 years
- Analysis skills
- Travel reimbursement
- Profit sharing
8d
Continuous Improvement Manager - Southeast Region
SUPPLYONE INC. —Bay Minette, AL
- $100,000 - $130,000 a year
- Full-time
- 5 years
- Analysis skills
- Agile
- Paid holidays
- Disability insurance
Quick Apply
Case Manager, Registered Nurse
CVS Health —Alabama
- $54,095 - $155,538 a year
- Full-time
- Remote
- Spanish
- Nursing
- Addiction Medicine
- Health insurance
- Dental insurance
Trust Operations & Consent Manager
Atrium Health —Centre, AL
- $51.05 - $76.60 an hour
- Full-time
- Remote
- Marketing
- 3 years
- Bachelor's degree
- Paid parental leave
- Disability insurance
Estimating Manager- Piping/Mechanical
Contractor Service and Fabrication, Inc. —Decatur, AL
- Full-time
- 7 years
- English
- Research
- Paid holidays
- Disability insurance
Quick Apply
Senior VP Credit Portfolio Manager
SouthPoint Bank —Birmingham, AL
- Full-time
- Background check
- 7 years
- Microsoft Excel
- Health insurance
- Dental insurance
Quick Apply
Development Manager – Affordable Housing / LIHTC
Zimmerman Properties —Montgomery, AL
- $110,000 - $150,000 a year
- Full-time
- Hybrid work
- Background check
- Microsoft Excel
- 5 years
- Health insurance
- Dental insurance
Quick Apply
7d
Territory Sales Manager - Birmingham, AL
OSG USA —Alabama
- $75,000 - $105,000 a year
- Microsoft Excel
- Microsoft Outlook
- Marketing
- Profit sharing
- Wellness program
Development Manager – Affordable Housing / LIHTC
Zimmerman Properties —Birmingham, AL
- $110,000 - $150,000 a year
- Full-time
- Hybrid work
- Background check
- Microsoft Excel
- 5 years
- Health insurance
- Dental insurance
Quick Apply
7d
Technical Sales Manager - Drilling Products
Minerals Technologies —Letohatchee, AL
- Full-time
- Construction site
- Marketing
- Public speaking
- Disability insurance
- Health insurance
Commission Territory Manager
CrossAmerica Partners —Birmingham, AL
- Full-time
- Marketing
- Merchandising
- Mid-level
Quick Apply

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Manager, Payment Integrity-COB/TPL /Subrogation

Centene -
Alabama

Apply Now

Job Details

Full-time
$87,700 - $157,800 a year
3 days ago

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Medical terminology

Full Job Description

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:
Develop, implement and manage strategic fraud, waste and abuse activities by maintaining state and federal requirements and monitoring trends/schemes

Oversee Coordination of Benefits (COB), Third Party Liability (TPL), and Subrogation recovery activities, including identification of other coverage, validation of recovery opportunities, coordination with internal operational teams, and timely resolution of provider, member, and carrier-related issues
Monitor internal and vendor and platform performance for COB/TPL/Subrogation programs, including savings, inventory, cycle times, quality outcomes, and adherence to recovery policies and regulatory requirements
Monitor business processes and systems to assure integrity and compliance in billing and claims payment
Lead teams of analysts to appropriately investigate all possible fraud, waste and abuse referrals
Develop customized fraud plans to meet contract and federal requirements
Develop educational materials to identify/validate waste activities as requested by the health plan and on an ad-hoc basis
Respond to RFP request and implement new policies per contractual obligation
Attend state/federal meetings as required by specific contracts
Prepare/present the FWA program to state/federal personnel upon request, specifically during readiness reviews, and immediately following the go live or upon state agency personnel changes
Review post-payment cases with appropriate parties to obtain refund
Prepare and distribute monthly and quarterly saving reports
Performs other duties as assigned
Complies with all policies and standards

Education/Experience:
Bachelor’s degree in Business, Healthcare, Criminal Justice, related field, or equivalent experience. 4+ years of medical claim investigation, compliance or fraud and abuse experience. Thorough knowledge of medical terminology required. Experience with Coordination of Benefits (COB), Third Party Liability (TPL), Subrogation, or healthcare recovery operations preferred. Previous experience in managed care environment and as a lead or supervisor of staff, including hiring, training, assigning work and managing performance preferred.

License/Certification: Medical records or coding license preferred.

Pay Range: $87,700.00 - $157,800.00 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

Apply Now

Refine Your Search

plan manager jobs in alabama

Manager, Payment Integrity-COB/TPL /Subrogation

Manager, Project Mgt (IC)

Area Process Manager - Paper

Sr. Manager, Forecasting & Business Planning

Production Center Manager - Title Operations (Remote)

PROGRAM MANAGER II

Supervisory Program Manager (Division Administrator)- Direct Hire

Sr Manager, Operations - AMZ8004.12

Area Process Manager - Woodyard

PBM Call Center Manager - Remote US

Continuous Improvement Manager - Southeast Region

Case Manager, Registered Nurse

Trust Operations & Consent Manager

Estimating Manager- Piping/Mechanical

Senior VP Credit Portfolio Manager

Development Manager – Affordable Housing / LIHTC

Territory Sales Manager - Birmingham, AL

Development Manager – Affordable Housing / LIHTC

Technical Sales Manager - Drilling Products

Commission Territory Manager

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