Manager, Provider Configuration Services

Centene Corporation•Remote-NY, NY

8d•$87,700 - $157,800•Remote

About The Position

The Manager, Provider Configuration Services represents the highest level of technical expertise in Provider Configuration, Provider, and Network Maintenance while providing leadership and partnering with Fidelis Care New York’s Senior and Executive Management. This people leader manages service-level agreements (SLAs), applies strong configuration knowledge, and drives process improvements. The role supports compliance and provider-maintenance work, new lines of business, innovation projects, contract configuration, and claims mass adjustments. It collaborates with resources across the organization to define, prioritize, staff, and implement business initiatives, and provides recommendations to the Director, Provider Configuration Services on resources, technology, and project lifecycle topics. The manager leads and develops cross-trained business analysts and coordinators who support organizational initiatives and ongoing business application maintenance. The position provides timely updates on staffing, technology, and opportunities, and collaborates across the organization to support initiatives while delivering high-quality customer service. The role is described as 90% remote with 10% travel for in-office meetings and trainings. The annual pay range is $87,700 to $157,800. Centene describes a comprehensive benefits package including competitive pay, health insurance, a 401(k), stock purchase plans, tuition reimbursement, paid time off, holidays, and flexible work schedules. Benefits may be subject to program eligibility.

Requirements

Bachelor’s degree or equivalent in a related field required.
Four to six years of related experience required.
Eight or more years of experience in Claims Configuration and Provider Network.
Five or more years working in TriZetto Facets.
Proficiency in Microsoft Office, Lotus Notes, and TriZetto Facets.
Working knowledge and experience in Provider Network and Claims Configuration.
Strong analytical and problem-solving skills, with the ability to work in a fast-paced environment.
Ability to communicate with all levels of management and with internal and external customers.
Ability to work effectively as a team member or independently.
Effective written communication skills for developing business specifications and requirements for technical and business stakeholders.

Nice To Haves

Three to five years of management experience preferred.
People leadership experience managing a team accountable for meeting organizational SLAs.
Strong understanding of configuration and the ability to identify and drive process improvements.
Facets experience is highly preferred.
Knowledge of health plan operations.
New York residents highly preferred; East Coast residents preferred.

Responsibilities

Manage SLAs and drive process improvements in Provider Configuration, Provider, and Network Maintenance.
Support compliance and provider-maintenance activities, new lines of business development, innovation projects, contract configuration, and claims mass adjustments.
Collaborate across the organization to define, prioritize, staff, and implement business initiatives.
Provide recommendations to the Director, Provider Configuration Services on resources, technology, and project lifecycle matters.
Lead and develop a team of cross-trained business analysts and coordinators supporting organizational initiatives and business application maintenance.
Provide timely updates on staffing, technology, and opportunities.
Collaborate across the organization to support large and small initiatives and provide high-quality customer service.