Manager, Provider Configuration Services

Centene Corp.; Oregon; Hybrid; USD 88,000 - 158,000; Full time

Job summary

Centene Corporation is seeking a senior Provider Configuration Manager to lead a team responsible for provider configuration, provider network maintenance, and related initiatives. The role partners with senior management to drive strategic improvements and ensure SLA adherence.

The incumbent will bring extensive TriZetto Facets experience, strong analytical skills, and a proven ability to collaborate across departments to deliver high-quality outcomes for health plan operations.

Qualifications

• Bachelors degree or equivalent required; management experience preferred.
• Eight+ years in Claims Configuration and Provider Network.
• Five+ years in TriZetto Facets; strong configuration knowledge.
• Proficiency with Microsoft Office and Lotus Notes; ability to drive improvements.

Responsibilities

• Lead and develop a cross-functional team responsible for provider configuration and network maintenance.
• Manage SLAs, drive process improvements, and coordinate with senior leadership.
• Collaborate across the organization on initiatives requiring resources and expertise.
• Provide timely staffing updates and strategic recommendations to leadership.

Skills

People leadership

Facets experience

Configuration knowledge

Analytical skills

Communication skills

Education

BA/BS in related field

Tools

TriZetto Facets

Microsoft Office

Lotus Notes

Job description

Position Purpose

Represents the highest level of technical expertise in the area of Provider Configuration, Provider, and Network Maintenance while providing leadership and partnering with Fidelis Care New York's Senior and Executive Management.

Key Details

People Leader managing SLAs, knows configuration well, and can drive process improvements. Facets experience and knowledge highly preferred.

• Supports initiatives and business as usual tasks required for Compliance and Provider maintenance, new lines of business development, and innovation projects, Contract Configuration, and Claims Mass Adjustments.
• Collaborates with resources across the organization to define, prioritize, staff, and implement business initiatives requiring resources and expertise.
• Provides recommendations to the Director, Provider Configuration Services on critical topics concerning resources, technology, and project lifecycle.
• Lead and develop a team of cross-trained business analysts and coordinators who support organizational initiatives and business as usual business application maintenance tasks.
• Provide updates on staffing, technology, and opportunities in an informative and timely fashion.
• Collaborate across the organization to support large and small initiatives while also providing high quality customer service.

Business Analysis Knowledge

Skilled to work in a fast paced environment. Must have strong analytical and problem solving skills.Customer Service: Skilled to communicate with all levels of Management, internal and external customers.

• Ability to work well as a member of a team or independently.

Effective Business Communication

Skilled in communicating with technical and business constituencies in writing effective business specifications and requirements.

Highly Preferred Experience/Skills

• People leadership experience managing a team with accountability for meeting organizational SLAs
• Strong understanding of configuration, with the ability to identify and drive process improvements
• Facets experience highly preferred
• Knowledge of health plan operations
• NY residents Highly Preferred
• East Coast residents preferred
• 90% Remote and 10% Travel for in office meetings/trainings

Education/Experience

BA/BS-Bachelors Degree or equivalent in related field required. Three to five years Management experience preferred. Eight or more years experience in Claims Configuration and Provider Network. Five or more years working in TriZetto Facets. Four to six years related experience required. Proficiency in Microsoft Office; Lotus Notes; TriZetto Facets. Provider Network and Claims Configuration working knowledge and experience.Pay Range: $87,700.00 - $157,800.00 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. 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
• a flexible approach to work with remote, hybrid, field or office work schedules

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 may be subject to program eligibility.

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