Senior Manager, Credentialing & Provider Data

Centene Corp.; Northern (KY); Hybrid; USD 88,000 - 158,000; Full time

Job summary

Centene Corp. in the United States seeks a Senior Manager of Credentialing and PDM to oversee credentialing and provider data entry from triage through enrollment and maintenance.

This role requires U.S. work authorization, NCQA credentialing knowledge, and leadership of a technical team with SQL Server experience, focusing on system updates, data analysis, and reporting while ensuring regulatory compliance.

Qualifications

• Bachelor’s degree or equivalent experience and 4 years of relevant experience.
• NCQA, credentialing, and provider data management knowledge required.
• 3+ years of supervisory/management experience.
• Preferred Portico, Amisys, CenProv experience.

Responsibilities

• Oversee credentialing and provider data management from triage to enrollment.
• Lead a technical team supporting system updates and reporting.
• Ensure provider records are updated and compliant with policies and regulations.
• Maintain provider directories and enrollment specifications accuracy.
• Ensure adherence to NCQA credentialing standards and state/federal requirements.

Skills

Leadership

Team management

Data analysis

Education

Bachelor's degree or equivalent experience

Tools

SQL Server

Portico

Amisys

CenProv

Job description

Centene Corp. in the United States seeks a Senior Manager of Credentialing and PDM to oversee credentialing and provider data entry from triage through enrollment and maintenance.

This role requires U.S. work authorization, NCQA credentialing knowledge, and leadership of a technical team with SQL Server experience, focusing on system updates, data analysis, and reporting while ensuring regulatory compliance.