Senior Grievance & Appeals Manager - Remote AZ

Centene Corp.; United States; Remote; USD 70,000 - 126,000; Full time

Benefits offered by this job

Competitive benefits

Flexible schedule

Hybrid work possibility

Job summary

Centene Corporation is seeking a Grievance & Appeals Coordinator in the United States. The role ensures timely processing of member grievances and provider appeals, serving as the primary State contact and overseeing day-to-day operations of the Grievance & Appeals team.

The ideal candidate holds a bachelor’s degree with 3+ years in healthcare or law related to grievances and appeals, including prior supervisory experience.

Qualifications

• Bachelor’s degree in related field or equivalent experience.
• 3+ years of experience in healthcare/law, grievances and appeals.
• Lead in a functional area with supervisory experience including hiring, training, assigning work and managing the performance of staff.

Responsibilities

• Ensure processing of all member grievances and provider appeals within contract time frames.
• Serve as the point of contact with the State and coordinate with multiple external constituencies.
• Monitor trends and provide monthly reporting to senior management.
• Investigate grievances according to contract requirements and company policy.
• Incorporate federal and state changes into the regulatory system for grievance and appeals.
• Provide training to agencies on procedures to comply with grievance and appeals requirements.
• Review and process incoming incident/accident reports.

Skills

Leadership

Cross-functional collaboration

Training & mentoring

Regulatory awareness

Education

Bachelor's degree or equivalent experience

Job description

Centene Corporation is seeking a Grievance & Appeals Coordinator in the United States. The role ensures timely processing of member grievances and provider appeals, serving as the primary State contact and overseeing day-to-day operations of the Grievance & Appeals team.

The ideal candidate holds a bachelor’s degree with 3+ years in healthcare or law related to grievances and appeals, including prior supervisory experience.