Payment Integrity Systems Specialist II

About the role

The Payment Integrity Systems Specialist II supports Centene’s payment integrity platform by analysing data, managing system enhancements, and ensuring accurate reporting. The role works closely with Operations, Technology, Finance and governance teams to maintain system reliability and drive operational improvements.

Key responsibilities

• Conduct moderately complex analysis of platform outputs, claims data, edit/rule behavior and workflow performance to identify exceptions and trends.
• Manage ServiceNow (or similar) incidents, defects and enhancement requests, documenting requirements and tracking status.
• Coordinate user‑acceptance testing, regression testing and release‑readiness activities, validating defects and communicating operational impacts.
• Develop and maintain dashboards, trackers and recurring reports to provide visibility into enhancements, defects, savings opportunities and performance metrics.
• Gather and analyse data using Excel, SQL, Power BI and other reporting tools to validate outputs and support decision‑making.
• Partner with cross‑functional stakeholders to clarify requirements, document decisions and support transformation workstreams.

Required profile

• Bachelor’s degree in healthcare, business, finance, information systems, data analytics or related field, or equivalent experience.
• Minimum 2 years of experience with payment integrity systems, managed‑care claims, data analytics, financial reporting or related technical healthcare functions.
• Working knowledge of managed‑care claims, payment integrity concepts, system workflows and operational controls.
• Experience with ticketing systems, UAT/testing documentation, dashboard creation and cross‑functional issue resolution.

Required skills

• Advanced Excel
• SQL (working proficiency)
• Power BI or similar data‑visualisation tools
• ServiceNow or comparable incident‑management platform
• UAT and regression testing documentation
• Dashboard and KPI development

What we offer

• Competitive salary range $63,600 – $114,600 per year
• Health insurance, 401(k) and stock purchase plans
• Tuition reimbursement and professional development opportunities
• Paid time off, holidays and flexible work arrangements (remote, hybrid, field or office)
• Equal‑opportunity employment in a diverse and inclusive environment