Centivo Benefits Overview

Leads complex cross-functional Commercial initiatives from discovery through implementation, stabilization, and closeout. Responsibilities include project planning, business analysis, requirements gathering, process mapping, workflow improvement, UAT coordination, implementation readiness, documentation, training, and change enablement. The role partners with Sales, Client Success, Implementation, Marketing, Finance, Legal, Product, Operations, and Technology teams to improve commercial processes and scalability.

Leads Centivo’s Claims Management Ancillary Services and Plan Documents functions, overseeing strategy, compliance, quality, performance, workforce planning, and process improvement. Ensures accurate and timely SPDs, SMMs, SBCs, amendments, claims audits, appeals, recoveries, subrogation, and No Surprises Act processes. Manages two functional leaders, develops team performance, monitors operational KPIs, partners cross-functionally, and serves as the operational authority for clients, brokers, TPAs, and stop-loss carriers.

Lead and coach a claims processing team for self-funded employer health plans, enforce SLAs and quality standards, manage claim inventory and backlog, develop policies and procedures, collaborate with Quality/Training and System teams, oversee appeals/subrogation/overpayments, and report performance metrics.