Manager, Provider Data Management

Centene Corporation

Manager of Provider Data Management overseeing provider enrollment and data accuracy for 28 million members. Leading operational performance and regulatory compliance in a fully remote role.

Posted 5/21/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $70,100 - $126,200 per yearWebsite

About the role

Key responsibilities & impact

Serve as the direct people leader for multiple teams responsible for Provider Enrollment, Auditing, and Provider Data Management & Updates.
Manage, coach, and develop staff through performance management, training, and career development.
Establish staffing models, productivity expectations, and cross ‑ functional alignment to support business and regulatory needs.
Update and maintain training materials, policies, and standard operating procedures to ensure consistent execution across teams.
Provide operational ownership and oversight of the health plan’s entire Provider Enrollment lifecycle , including initial enrollment, revalidation, updates, and terminations.
Oversee provider enrollment auditing activities to ensure compliance with state, federal, NCQA, CMS, and contractual requirements.
Provide oversight and governance of the Centene Corporate credentialing process , ensuring alignment, issue escalation, and audit readiness at the health plan level.
Partner with internal and external stakeholders to resolve enrollment, credentialing, and data discrepancies.
Ensure the timely and accurate processing of provider data updates (adds, changes, and terminations) across all systems.
Develop and maintain data integrity through audits, controls, reporting, and root ‑ cause analysis.
Establish and monitor KPIs and operational goals for Provider Enrollment and Provider Data Management functions.
Manage encounter response files and error correction processes related to provider data.
Lead provider data and enrollment audit preparation and execution, including internal, state, federal, and accreditation audits.
Track audit findings, corrective action plans, and ongoing monitoring activities.
Schedule and oversee monthly provider verifications related to enrollment specifications and demographic changes, particularly for designated specialty types.
Responsible for systems implementation, enhancements, and process improvements related to provider enrollment and data management.
Coordinate materials and provider data support for Requests for Applications (RFAs) , new business, and expansions.
Collaborate with internal business partners to support enterprise initiatives and regulatory changes

Requirements

What you’ll need

Bachelor’s degree in related field or equivalent experience
4+ years of contracting, provider data management, or data analytics experience
Supervisor/lead experience preferred

Benefits

Comp & perks

competitive pay
health insurance
401K and stock purchase plans
tuition reimbursement
paid time off plus holidays
a flexible approach to work with remote, hybrid, field or office work schedules

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

provider enrollmentauditingdata managementdata integrityroot cause analysisKPI monitoringperformance managementtraining developmentprocess improvementscontracting

Soft Skills

leadershipcoachingstaff developmentcross-functional collaborationcommunicationproblem-solvingorganizational skillsoversightstakeholder engagementaudit readiness