Remote Appeals Supervisor: Lead, Coach & Improve

Centene Corporation; Missouri; Remote; USD 64,000 - 115,000; Full time

Job summary

Centene Corporation seeks a Remote Supervisor, Appeals to manage a team handling appeals, disputes and reconsiderations with a focus on accuracy, timeliness and regulatory compliance. The role requires a strong background in managed care, and leadership to develop talent and drive improvements.

The position requires a Bachelor's degree and 4+ years of related experience, with availability to work Central Time Zone hours.

Qualifications

• Requires a Bachelor's degree and 4+ years of related experience.
• Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Responsibilities

• Monitors and tracks appeals, disputes, and reconsiderations issues to ensure documentation, processing, and resolution is in accordance with established policies and procedures.
• Provides expert knowledge and guidance based on experience to the appeals, disputes, and reconsiderations team for issue resolution and processing to ensure compliance with NCQA requirements.
• Maintains knowledge of contract requirements, policies, procedures, and performance standards.
• Ensures team’s compliance with contract requirements, policies, procedures, and performance standards.
• Identifies opportunities for process and quality improvements with the team.
• Evaluates team performance and provides feedback on performance, goals, and career milestones.
• Provides coaching and guidance to team to ensure timely resolution of appeals, disputes and reconsiderations.
• Assists with onboarding, hiring and training team members.
• Leads and champions change within scope of responsibility.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education

Bachelor's degree

Job description

Centene Corporation seeks a Remote Supervisor, Appeals to manage a team handling appeals, disputes and reconsiderations with a focus on accuracy, timeliness and regulatory compliance. The role requires a strong background in managed care, and leadership to develop talent and drive improvements.

The position requires a Bachelor's degree and 4+ years of related experience, with availability to work Central Time Zone hours.