Grievance & Appeals Manager — Remote, Oregon RN

Centene Management Company LLC; Oregon; Hybrid; USD 70,000 - 126,000; Full time

Benefits offered by this job

Health insurance

401K plan

Stock purchase

Tuition reimbursement

Paid time off

Flexible schedules

Job summary

Centene Management Company LLC is seeking a Grievance & Appeals Coordinator for a remote role aligned to Pacific Standard Time. Preference for an Oregon resident with an active RN license.

You will ensure timely processing of member grievances and appeals, coordinate with state/federal entities, and report monthly trends to senior leadership. Responsibilities include applying regulatory changes to the system, training agencies, reviewing incident reports, and driving corrective actions with

Qualifications

• Bachelor's degree or equivalent experience.
• 3+ years in healthcare/law, grievances and appeals.
• Experience as a lead managing cross-functional teams on large projects or supervisory experience including hiring, training, and performance management.

Responsibilities

• Process member grievances and appeals in accordance with contractual timeframes and regulations.
• Act as primary contact with state agencies and coordinate with local, state, and federal entities.
• Provide monthly reporting on trends to senior management and implement corrective actions.

Skills

Attention to detail

Communication

Leadership

Education

Bachelor's degree or equivalent experience

RN licensure in Oregon

Job description

Centene Management Company LLC is seeking a Grievance & Appeals Coordinator for a remote role aligned to Pacific Standard Time. Preference for an Oregon resident with an active RN license.

You will ensure timely processing of member grievances and appeals, coordinate with state/federal entities, and report monthly trends to senior leadership. Responsibilities include applying regulatory changes to the system, training agencies, reviewing incident reports, and driving corrective actions with