Supervisor, Appeals

🔥 0 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $63.6k - $114.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

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

• Supervise processing and review of appeals, disputes, and reconsiderations • Escalate the most complex issues in accordance with state and NCQA requirements • Supervise day-to-day activities and guide the team to ensure timely processing • Monitor and track issues to ensure proper documentation, processing, and resolution • Provide expert guidance for issue resolution and processing • Ensure team compliance with contract requirements, policies, procedures, and performance standards • Identify opportunities for process and quality improvements • Evaluate team performance and provide feedback on performance, goals, and career milestones • Coach and guide the team to ensure timely resolution • Assist with onboarding, hiring, and training team members • Lead and champion change within the scope of responsibility • Perform other duties as assigned

🎯 Requirements

• Bachelor's degree and 4+ years of related experience, or equivalent experience acquired through applicable knowledge, duties, scope and skill • Experience in managed care, appeals, and claims • People leadership experience • Knowledge of state and National Committee for Quality Assurance (NCQA) requirements • Knowledge of contract requirements, policies, procedures, and performance standards • Availability to work Central Time Zone hours • Compliance with all policies and standards

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity