[Remote] Program Manager – PA Governance

Note: The job is a remote job and is open to candidates in USA. Centene Corporation is a diversified national organization focused on transforming the health of communities. The Program Manager will lead enterprise-wide Prior Authorization governance, ensuring effective execution across regulatory, operational, and clinical initiatives while partnering with organizational leaders to drive alignment and measurable outcomes.

Responsibilities

• Identify opportunities to increase efficiency, improve service levels, and ensure regulatory and PA compliance through enhanced, standardized operations and governance practices
• Develop and execute strategies to realize PA improvement opportunities, ensuring enterprise‑level prioritization, clear decision rights, and appropriate resource alignment
• Manage multiple PA initiatives through the full project lifecycle, including requirements gathering, governance intake, development of project plans and schedules, resource and budget management, execution, deployment, and closure
• Support structured PA governance cycles by ensuring initiatives are evaluated, prioritized, approved, and sequenced in alignment with enterprise standards and readiness criteria
• Utilize corporate and industry‑standard project management and governance tools to manage PA initiatives effectively, including standardized trackers, RAID logs, and decision artifacts
• Maintain detailed and accurate PA program documentation, including action items, risk and issue logs, mitigation plans, and governance decisions, ensuring auditability and traceability
• Maintain accurate and up‑to‑date trackers, RAID logs, and documentation across multiple PA workstreams to support transparency and leadership oversight
• Compile, format, and validate review packets and governance decision materials to ensure consistency, completeness, and decision‑readiness for leadership review
• Coordinate and validate market, clinical, and SME inputs to ensure they are accurately incorporated into final PA governance materials
• Partner with analytics, medical economics, and operations teams to review financial and operational claims data prior to governance review and decision‑making
• Ensure ad‑hoc PA requests are logged, tracked, prioritized, and either executed or formally deferred into subsequent governance cycles
• Maintain a centralized PA documentation repository as the single source of truth for governance artifacts, decisions, and reference materials
• Provide strong leadership and communicate PA program and governance status to stakeholders at all levels, including executive summaries, dashboards, and presentations
• Lead cross‑functional governance and working sessions with Operations, Clinical, Finance, Analytics, Technology, and Compliance partners to meet enterprise objectives and stakeholder expectations
• Negotiate with stakeholders to secure resources, resolve cross‑functional dependencies, and mitigate risks while maintaining alignment to PA governance standards
• Provide functional and operational expertise related to PA programs, requirements, and workflows to support informed decision‑making

Skills

• Bachelor's degree in Business Administration, Healthcare Administration, related field, or equivalent experience
• 5+ years project implementation, product or program management experience
• Strong leadership and communication skills
• Experience in managing multiple PA initiatives through the full project lifecycle
• Ability to utilize corporate and industry-standard project management and governance tools
• Experience in maintaining detailed and accurate program documentation
• Ability to compile, format, and validate review packets and governance decision materials
• Experience in coordinating and validating market, clinical, and SME inputs
• Ability to partner with analytics, medical economics, and operations teams
• Experience in logging, tracking, prioritizing ad-hoc PA requests
• Ability to maintain a centralized PA documentation repository
• Experience in leading cross-functional governance and working sessions
• Ability to negotiate with stakeholders to secure resources and resolve dependencies
• Functional and operational expertise related to PA programs, requirements, and workflows
• Master's degree
• Managed care or prescription benefit management experience

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• A flexible approach to work with remote, hybrid, field or office work schedules
• Total compensation may also include additional forms of incentives
• Benefits may be subject to program eligibility

Company Overview