Manager, Provider Data Management

Centene
Illinois
Workplace: RemoteFull timeUSD 70,100 - 126,200 annuallyFunction: Communications, PR & CommunityExperience: 3+ yearsEducation: bachelorsSkills: ["Leadership","Performance management","Training","Stakeholder collaboration","Process improvement"]

Manage provider data management projects and policies for the Illinois Health Plan, focusing on provider directories, contract setup, and operational improvements that support claims adjudication. Oversee staff performance and production/quality metrics, develop and maintain reporting and workflows, and collaborate with Credentialing and Information Systems on briefs, business requirements, and process models. Lead training, resolve cross-department issues, and maintain provider data integrity guidelines for delegated credentialing vendors.

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FursaFursa
Centene
Centene
1 month ago

Manager, Provider Data Management

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Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 20 days agoStatus: Live

Job Summary

Manage provider data management projects and policies for the Illinois Health Plan, focusing on provider directories, contract setup, and operational improvements that support claims adjudication. Oversee staff performance and production/quality metrics, develop and maintain reporting and workflows, and collaborate with Credentialing and Information Systems on briefs, business requirements, and process models. Lead training, resolve cross-department issues, and maintain provider data integrity guidelines for delegated credentialing vendors.
Location: Illinois
Workplace: Remote
Employment Type: Full time
Job Function: Communications, PR & Community
Seniority: Manager level

Key Responsibilities

  • •Supervise staff and monitor performance via reviews, one-on-ones, and monthly statistics.
  • •Oversee provider data management projects, policies, and procedures, including provider directories and provider contract setup.
  • •Serve as main point of contact for internal departments on projects requiring business application changes (provider, contracts, and claims).
  • •Define reporting and information initiatives, conduct ad-hoc reporting, and maintain provider data integrity guidelines for delegated credentialing vendors.
  • •Develop workflows, protocols, and process models; maintain and revise data analysis programs; manage input data from internal and external sources.
Travel: Low travel

Pay and Benefits

Salary: USD 70,100 - 126,200 annually
Perks:Health Insurance401kEquityLearning BudgetPaid LeaveRemote Work

Key Requirements

  • •Bachelor’s degree in business administration, Health Care, or a related field.
  • •1-3 years management experience in a business setting.
  • •Minimum 3 years’ experience working in a health care setting, preferably with provider relations, provider data services, information technology, or claims operations.
  • •Experience developing new business processes and procedures.
  • •3 years leadership experience with direct reports (preferred).
Experience:3+ yearsHealthcareClaims
Education:Bachelor's in business administration, Health Care, or a related field
Skills:LeadershipPerformance managementTrainingStakeholder collaborationProcess improvement

Eligibility

Work Authorization:Authorization required. Sponsorship not provided.

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn