Manager, Provider Data Management

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🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $70.1k - $126.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📊 Data Scientist

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Healthcare Insurance • Non-profit • Social Impact

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• managing the activities that support all provider data management projects, policies and procedures, mainly directories along with provider contract setup activities • overseeing the development of reports to support the strategic and operational requirements of the department • supervising staff and directing and monitoring the staff activity • conducting reviews and providing monthly statistics to staff on their performance • ensuring staff is meeting both quality and production scores • maintaining detailed understanding and working knowledge of business applications specifically provider data management, provider reimbursement, and claims processing on the system • identifying and implementing value-added programs and initiatives that support and enhance network contracting to achieve operational efficiency • acting as main contact for internal departments on projects that require changes to business applications (provider, contracts, and claims) • meeting with internal departments to identify project requirements and ensure satisfactory project completion • working with Information Systems Department on special projects, including writing project briefs and assisting with the drafting and reviewing of BARRs and BSDs • developing cost benefit analysis for projects to assist in prioritization and project justification • conducting training for both internal and external departments on provider data services policies and procedures • resolving issues within internal departments related to interpretation of contracts or policies

🎯 Requirements

• Bachelor's degree in business administration, Health Care, or a related field • 1-3 years management experience in a business setting required • Minimum (3) years' experience working in a health care setting, preferably with a background in provider relations, provider data services, information technology or claims operations • Experience developing new business processes and procedures • (3) years leadership experience with direct reports • Provider directory experience

🏖️ Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules