Remote Appeals Supervisor: Lead Managed Care Reviews

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

Benefits offered by this job

Health insurance

401K

Stock purchase plans

Tuition reimbursement

Paid time off

Job summary

Centene Corporation Remote Supervisor, Appeals leads a team focused on accurate, timely and compliant outcomes in a managed care setting. The role requires a Bachelor’s degree and 4+ years of related experience, with availability to work Central Time Zone hours.

You will coach staff, monitor appeals, disputes and reconsiderations, ensure NCQA and contract compliance, and drive process improvements while onboarding new team members and leading organizational change.

Qualifications

• Bachelor's degree and 4+ years of related experience.
• Experience in managed care, appeals, and claims.
• Remote position requires availability to work Central Time Zone hours.

Responsibilities

• Monitor appeals, disputes, and reconsiderations to ensure documentation, processing, and resolution per policies.
• Provide expert guidance to the team for issue resolution and NCQA compliance.
• Maintain knowledge of contract requirements and performance standards.
• Ensure team compliance with contract requirements and standards.
• Identify opportunities for process and quality improvements.
• Evaluate team performance and provide feedback on goals and milestones.
• Coach and guide team to timely resolution of appeals, disputes and reconsiderations.
• Assist with onboarding, hiring, and training of team members.
• Lead change within scope of responsibility.
• Perform other duties as assigned.
• Comply with all policies and standards.

Skills

People leadership

Appeals experience

Managed care

Coaching

Process improvement

Education

Bachelor's degree

Job description

Centene Corporation Remote Supervisor, Appeals leads a team focused on accurate, timely and compliant outcomes in a managed care setting. The role requires a Bachelor’s degree and 4+ years of related experience, with availability to work Central Time Zone hours.

You will coach staff, monitor appeals, disputes and reconsiderations, ensure NCQA and contract compliance, and drive process improvements while onboarding new team members and leading organizational change.