[Hiring] Manager, Provider Configuration Services @Centene Corporation

Role Description

Represents the highest level of technical expertise in the area of Provider Configuration, Provider, and Network Maintenance while providing leadership and partnering with Fidelis Care New York’s Senior and Executive Management.

• People Leader managing SLAs, knows configuration well, and can drive process improvements. Facets experience and knowledge highly preferred.
• Supports initiatives and business as usual tasks required for Compliance and Provider maintenance, new lines of business development, and innovation projects, Contract Configuration, and Claims Mass Adjustments.
• Collaborates with resources across the organization to define, prioritize, staff, and implement business initiatives requiring resources and expertise.
• Provides recommendations to the Director, Provider Configuration Services on critical topics concerning resources, technology, and project lifecycle.
• Lead and develop a team of cross-trained business analysts and coordinators who support organizational initiatives and business as usual business application maintenance tasks.
• Provide updates on staffing, technology, and opportunities in an informative and timely fashion.
• Collaborate across the organization to support large and small initiatives while also providing high quality customer service.

Qualifications

• Skilled to work in a fast paced environment. Must have strong analytical and problem solving skills.
• Skilled to communicate with all levels of Management, internal and external customers.
• Ability to work well as a member of a team or independently.
• Skilled in communicating with technical and business constituencies in writing effective business specifications and requirements.

Requirements

• People leadership experience managing a team with accountability for meeting organizational SLAs.
• Strong understanding of configuration, with the ability to identify and drive process improvements.
• Facets experience highly preferred.
• Knowledge of health plan operations.
• NY residents Highly Preferred.
• East Coast residents preferred.
• 90% Remote and 10% Travel for in office meetings/trainings.

Education/Experience

• BA/BS-Bachelors Degree or equivalent in related field required.
• Three to five years Management experience preferred.
• Eight or more years experience in Claims Configuration and Provider Network.
• Five or more years working in TriZetto Facets.
• Four to six years related experience required.
• Proficiency in Microsoft Office; Lotus Notes; TriZetto Facets.
• Provider Network and Claims Configuration working knowledge and experience.

Benefits

• Competitive pay.
• Health insurance.
• 401K and stock purchase plans.
• Tuition reimbursement.
• Paid time off plus holidays.
• Flexible approach to work with remote, hybrid, field or office work schedules.