jobapplier

Supervisor, Provider Data Management

Centene

Skills

Required

  • provider data management
  • combined management
  • data analysis
  • customer service
  • claims processing / billing / provider relations / contracting

Preferred

  • data management
  • Portico
  • CenProv

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

About Centene

  • $56,200.00 - $101,000.00 per year At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day.
  • You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective.

Responsibilities

  • Manage the daily operations of all provider data management functions.
  • Direct provider data management related activities based on plan and contract specifications and standard business rules – includes data analysis and entry, review of data via internet sites and other systems, usage of multiple systems and applications to validate data is complete and accurate, and investigation and resolution of data issues.
  • Manage the end-to-end provider data entry and maintenance to ensure accurate and timely setup for claims payment, member assignment and directory display
  • Investigate and resolve complex provider data management issues
  • Identify trends and recommend improvements to mitigate potential issues
  • Lead task assignment for team’s workflow and distribution
  • Monitor team performance to ensure established and provider data quality benchmarks are met
  • Facilitate meetings with Health Plan representatives
  • Train and mentor
  • Provider Data Management Analyst I, II, and Team Leads Performs other duties as assigned

Requirements

  • Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.
  • Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.
  • Candidates must be located in Indiana to qualify for this position.
  • Complies with all policies and standards Education/Experience: Bachelor’s degree in related field or equivalent experience.
  • 3+ years of combined management and provider data management, data analysis, and customer service experience preferably with healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience in a managed care, insurance, or medical office environment.
  • Experience performing and leading teams.

Preferred

  • Experience with provider data management, Portico, and CenProv is highly preferred.

Pay

  • 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

  • It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
  • 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.
  • Benefits may be subject to program eligibility.