Remote Senior Manager - Credentialing & Provider Data

Centene Corporation; Missouri; Hybrid; USD 88,000 - 158,000; Full time

Job summary

Centene Corporation is seeking a Senior Manager of Credentialing and PDM to oversee all direct processes of credentialing and provider data entry, from triage through enrollment and data maintenance.

The role requires a strong technical background and leadership experience, with expertise in SQL Server and provider data management. The position emphasizes compliance with NCQA standards and state/federal regulations, and offers various work arrangements.

Qualifications

• Bachelor’s degree or equivalent experience.
• NCQA, credentialing, and provider data management knowledge required.
• 3+ years of supervisory/management experience.

Responsibilities

• Lead a team supporting credentialing and provider data management from technical perspective, including system updates and reporting.
• Oversee credentialing and re-credentialing of physicians, mid-level practitioners, and organizational providers.
• Manage provider data records updates in line with health plan policies and state/federal regulations.
• Ensure compliance with KPIs, NCQA standards, and regulatory requirements.
• Oversee updates to and production of provider directories and enrollment specifications.

Skills

SQL Server

Provider Data Management

Credentialing

Leadership

Managed care operations

Education

Bachelor's degree or equivalent

Tools

Portico

Amisys

CenProv

Job description

Centene Corporation is seeking a Senior Manager of Credentialing and PDM to oversee all direct processes of credentialing and provider data entry, from triage through enrollment and data maintenance.

The role requires a strong technical background and leadership experience, with expertise in SQL Server and provider data management. The position emphasizes compliance with NCQA standards and state/federal regulations, and offers various work arrangements.