Grievance & Appeals Lead - Healthcare Compliance (AZ)

Centene Corp.; Phoenix (AZ); Hybrid; USD 70,000 - 126,000; Full time

Benefits offered by this job

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off

Flexible work schedules (remote/hybrid

Job summary

Centene Corporation in Arizona is seeking a Grievance & Appeals Leader to ensure proper processing of member grievances and appeals, serving as the point of contact with the State. This role manages day-to-day operations of the Grievance & Appeals Coordinators and ensures work aligns with contractual timelines.

Ideal candidates have a Bachelor's degree and 3+ years in healthcare law, grievances, and appeals, with prior supervisory experience.

Qualifications

• 3+ years of healthcare/law, grievances and appeals experience.
• Experience leading cross-functional teams on large-scale projects.
• Supervisory experience including hiring, training, and performance management.

Responsibilities

• Manage day-to-day responsibilities of the Grievance & Appeals Coordinators.
• Ensure department processes all appeals and grievances within contractual timelines and legal requirements.
• Monitor appeals and grievances and provide monthly trend reports to senior management.
• Work with state, local, and federal agencies and the public on grievance and appeals.
• Integrate federal and state law changes into the regulatory system.
• Provide training and direction to agencies in developing procedures to comply with grievance and appeals.
• Review and process incoming incident/accident reports.
• Recommend solutions and corrective measures to prevent recurrences.

Skills

Leadership

Regulatory compliance

Stakeholder communication

Project coordination

Education

Bachelor’s degree in related field or equivalent experience

Job description

Centene Corporation in Arizona is seeking a Grievance & Appeals Leader to ensure proper processing of member grievances and appeals, serving as the point of contact with the State. This role manages day-to-day operations of the Grievance & Appeals Coordinators and ensures work aligns with contractual timelines.

Ideal candidates have a Bachelor's degree and 3+ years in healthcare law, grievances, and appeals, with prior supervisory experience.