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Centene Corporation: Grievance And Appeals Analyst

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Centene CorporationSmithville Flats, NY
  • You could be the one who changes everything for our 25 million members.
  • Centene is transforming the health of our communities, one person at a time.
  • As a diversified, multi-national organization, youll have access to competitive benefits including a fresh perspective on workplace flexibility.
  • Position Purpose: Ensure appropriate processing of member grievance appeals, provider appeals, or request for a State Fair Hearing.
  • Perform duties as the point of contact with the State.
  • Manage the day to day responsibilities of the Grievance & Appeals Coordinators.
  • Ensure that the Grievance and Appeals department processes all appeals and grievances in accordance with referred time frames and other contractual legal requirementsMonitor appeals and grievances and provide senior management with monthly reporting on trendsEnsure that all members and provider grievances are processed and investigated according to contract requirementsWork with various external constituencies, i.
  • 3+ plus years of experience in healthcare/law, grievances and appeals.
  • Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
  • 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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