Remote-Eligible Provider Data & Credentialing Manager

Centene Management Company LLC; Missouri; Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements

Job summary

Centene Management Company LLC is seeking a leader to manage credentialing and provider data management across multiple units. You will oversee credentialing, provider setup, and ensure adherence to NCQA, CMS, and DHHS standards while collaborating with plans and departments on initiatives.

The role requires guiding cross-functional teams on large projects, driving process improvements, and ensuring accurate staff performance and training.

Qualifications

• Bachelor’s degree in related field or equivalent experience.
• 5+ years of combined management and provider data management, credentialing or healthcare operations experience.
• Experience as a lead managing cross functional teams on large scale projects or supervising staff.

Responsibilities

• Oversee credentialing and re-credentialing of physicians, mid-level practitioners and organizational providers.
• Ensure provider data management and setup processes for claims payment and directory display.
• Ensure compliance with NCQA, CMS, DHHS and other regulatory standards; participate in accreditation activities.
• Identify opportunities to improve cost, quality and efficiency; monitor regulatory sanction reports.

Skills

Cross-functional leadership

Project management

Regulatory compliance knowledge

Education

Bachelor's degree or equivalent experience

Job description

Centene Management Company LLC is seeking a leader to manage credentialing and provider data management across multiple units. You will oversee credentialing, provider setup, and ensure adherence to NCQA, CMS, and DHHS standards while collaborating with plans and departments on initiatives.

The role requires guiding cross-functional teams on large projects, driving process improvements, and ensuring accurate staff performance and training.