Manager, Behavioral Health Appeals
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Florida • United States
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Salary
💰 $75,300 - $135,400 per year
About the role
- Manages the correspondence and/or appeals, disputes, and reconsiderations process
- Manages issues and provides guidance on the review and timely processing
- Maintains expert knowledge of contract requirements, policies, procedures, and performance standards
- Ensures team’s compliance with contract requirements, policies, and procedures
- Reviews reporting and analyzes activities to identify trends and provides recommendations
- Provides expert knowledge, guidance and education to team based on experience
- Works with team and leadership to identify opportunities for process and quality improvement
- Assists with onboarding, hiring, and training
- Leads and champions change within scope of responsibility
Requirements
- Requires a Bachelor's degree and 5+ years of related experience
- 2+ years supervisory experience preferred
- Advanced knowledge of NCQA and state Medicaid program requirements preferred
- Advanced knowledge of appeals process preferred
- RN with compact license with BH background or LPC highly preferred
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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
contract requirementspoliciesproceduresperformance standardsreportingdata analysisprocess improvementquality improvementonboardingtraining
Soft Skills
guidanceleadershipcommunicationteam collaborationproblem-solvingchange management
Certifications
Bachelor's degreeRN compact licenseLPC