Job Description

Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Manage the daily operations of all provider data management functions. Direct provider data management related activities based on plan and contract specifications and standard business rules – includes data analysis and entry, review of data via internet sites and other systems, usage of multiple systems and applications to validate data is complete and accurate, and investigation and resolution of data issues.

• Manage the end-to-end provider data entry and maintenance to ensure accurate and timely setup for claims payment, member assignment and directory display

• Investigate and resolve complex provider data management issues

• Identify trends and recommend improvements to mitigate potential issues

• Lead task assignment for team’s workflow and distribution

• Monitor team performance to ensure established and provider data quality benchmarks are met

• Facilitate meetings with Health Plan representatives

• Train and mentor Provider Data Management Analyst I, II, and Team Leads
• Performs other duties as assigned

• Complies with all policies and standards

Education/Experience: Bachelor’s degree in related field or equivalent experience. 3+ years of combined management and provider data management, data analysis, and customer service experience preferably with healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience in a managed care, insurance, or medical office environment. Experience performing and leading teams.

This position is 100% remote within the island of O'ahu, Honolulu, Hawaii. Candidates are required to reside within the island to be considered. Monthly in person team meetings at Honolulu office are required.

Pay Range: $54,000.00 - $97,100.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Job Tags

Holiday work, Contract work, Remote job, Flexible hours,

Similar Jobs