Centivo

The Claims Business Analyst will triage operational issues, lead projects to improve claims team efficiency, and coordinate with business units and vendors during implementations. They are responsible for analyzing operational reports, developing KPIs, and acting as a liaison between business and technical resources to ensure system requirements are met.

The Claims Adjustor is responsible for reviewing, assessing, and adjudicating healthcare claims for self-funded employer groups in accordance with plan policies. They must maintain production and quality standards while collaborating with internal teams to resolve discrepancies and process claims accurately.

Conduct pre-payment and post-payment claims audits to ensure financial accuracy and adherence to processing standards. Identify quality trends and collaborate with leadership to implement corrective actions and performance improvement plans.

Own and grow strategic relationships with large enterprise employer clients, serving as a trusted advisor to senior HR and Finance leaders. Lead the end-to-end renewal strategy and orchestrate cross-functional teams to ensure a high-touch, white-glove client experience.

The Director of Product Management owns the stop loss and captive product portfolio, defining how risk is structured, priced, and transferred. They lead the full product lifecycle from design and underwriting alignment to reinsurance structure and performance management.

This role serves as the subject matter expert on regulatory compliance for self-funded and level-funded health plan products, owning all mandated compliance reporting obligations including CMS Section 111, RxDC, and PCORI filings. Key duties also involve administering Gag Clause Attestation, leading Transparency in Coverage compliance, and supporting No Surprises Act/IDR processes.