Senior Manager, Credentialing & Provider Data Systems

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

Remote, hybrid, field or office work

Job summary

Centene Management Company LLC seeks a Senior Manager of Credentialing and PDM to oversee credentialing and provider data entry from triage through enrollment and ongoing maintenance.

The role leads a technical team, drives system updates and reporting, and ensures adherence to NCQA standards and applicable laws. It also manages provider directories and enrollment specifications while shaping training materials and procedures.

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 experience with Portico, Amisys, CenProv.

Responsibilities

• Oversee credentialing and provider data management from triage to provider enrollment and data maintenance.
• Lead a technical team, including system updates and reporting, for credentialing and PDM.
• Ensure updates to provider records align with health plan policies and state/federal regulations.
• Ensure compliance with NCQA credentialing standards and related requirements.
• Manage updates to and production of hard copy and online provider directories.
• Develop and manage training materials, policies, and procedures.

Skills

Strong technical background

Experience leading technical teams

Hands-on SQL Server

PDM knowledge

Credentialing & managed care ops

Education

Bachelor’s degree or equivalent experience

Tools

Portico

Amisys

CenProv

Job description

Centene Management Company LLC seeks a Senior Manager of Credentialing and PDM to oversee credentialing and provider data entry from triage through enrollment and ongoing maintenance.

The role leads a technical team, drives system updates and reporting, and ensures adherence to NCQA standards and applicable laws. It also manages provider directories and enrollment specifications while shaping training materials and procedures.