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Supervisor, Credentialing

This job is available in 1 locations

Supervisor, Credentialing

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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.

Candidates must live within a commutable distance to Buffalo, NY area.

Position Purpose: Supervise the credentialing function and staff. Plan, coordinate, and monitor Quality Initiatives (QI) projects.

  • Oversee the day to day operations of the Credentialing department
  • Monitor critical credentialing activities/processes and update management of issues
  • Ensure compliance with company standards, NCQA or URAC, State and Federal policies and regulations
  • Develop reports on credentialing activities and recommend improvements to ensure goals are met
  • Ensure the credentialing database remains current and accurate
  • Review and update credentialing program descriptions, policies and procedures
  • Research benchmark and industry standards
  • Analyze, develop, implement and monitor quality initiatives to achieve healthy outcomes for assigned projects
  • Work closely with applicable networks to determine accuracy and appropriateness of the credentialing status
Education/Experience: Bachelor’s degree in related field or equivalent experience. 3+ years of credentialing experience in the healthcare industry. Experience with NCQA or URAC and state credentialing requirements. Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.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.

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