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Supervisor, Provider Data Management

Charlotte, North Carolina Apply Now Job ID 1148952 Category Network Development & Contracting Organization Carolina Complete Health Schedule Full-time

Position Purpose: Establish and monitor Key Performance Indicators (KPIs). Responsible for timely completion of provider data changes as well as the maintenance, integrity and validity of provider data and provider data policies, procedures and work processes.

  • Manage and report on provider data integrity, accuracy, and trends and provide recommendations
  • Oversee the resolution of claims payment and provider set-up issues
  • Create and maintain KPIs and goals for provider data management team
  • Plan, coordinate and participate in scheduled and unscheduled meetings with providers to conduct orientations, train providers on health plan policies and procedures, deliver materials or inquire about contracting with our health plan
  • Report team performance metrics identifying and implementing improvements to increase and maintain productivity and effectiveness
  • Collaborate with various cross-functional departments on complex and escalated issues to identify, report on and implement solutions

  • Qualifications:

    Education/Experience: Bachelor’s degree in related field or equivalent experience. 3+ years of contracting or provider data management experience in a managed care or insurance environment. Proficient in Microsoft Office applications including Access and Excel. Supervisor/lead experience preferred.

    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.

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