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Supervisor, Grievance & Appeals

Clayton, Missouri Apply Now Job ID 1165081 Category Leadership Organization Centene Corporation Schedule Full-time
Description:
Position Purpose:

  • Ensure that the Appeals & Grievance department processes all appeals, grievances and complaints in accordance with standards and the corporation’s policies and procedures
  • Serve as a resource to the team regarding escalated or complex issues, process and systems issues, and regulatory updates
  • Monitor and distribute team’s case load and ensure adequate coverage
  • Monitor and evaluate performance standards and provide daily feedback and guidance of problem resolution
  • Identify and develop opportunities for process improvements and work with various departments to ensure problems are corrected to prevent recurrences
  • Train and onboard new team members
  • Qualifications:

    Supervise the day to day operations of the Appeals and Grievance (A&G) staff and functions within the department ensuring productivity and quality metrics are met. Support the team on escalated or complex issues and monitor and distribute case load.

    Education/Experience:
    Bachelor’s degree in a related field or equivalent experience. 2+ years of appeals and grievances processing experience in a healthcare or managed care setting preferred. Experience in healthcare law preferred.

     

    Candidates experienced in Medicare and managed care highly preferred.

    Candidates with a minimum of 1 year experience in a supervisory role highly 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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