Supervisor, Correspondence

Centene•Tempe, AZ

3d•Remote

About The Position

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Position Purpose: Supervises drafting and processing of correspondence in accordance with National Committee for Quality Assurance (NCQA) requirements. Supervises day-to-day activities and provides guidance to the team to ensure correspondence is reviewed and processed timely. Applicants for this job have the flexibility to work remote from home and preferably reside in AZ, MT, CO, NV, WA, OR, ID. Monitors and tracks all correspondence issues and researches to ensure documentation, processing, and resolution is in accordance with established policies and procedures Provides expert knowledge and guidance based on experience to the correspondence team for issue resolution and processing to ensure compliance with state and National Committee for Quality Assurance (NCQA) requirements Maintains knowledge of contract requirements, policies, procedures, and ensures correspondence team's compliance with contract requirements, policies, procedures, and performance standards Works with team to identify opportunities for process and quality improvements within the denial processing and review process Evaluates team performance and provides feedback regarding performance, goals, and career milestones Provides coaching and guidance to team to ensure timely documentation for services and improve processing and quality of correspondence Assists with onboarding, hiring, and training of team members Leads and champions change within scope of responsibility Performs other duties as assigned Complies with all policies and standards

Requirements

Requires a Bachelor's degree and 4+ years of related experience.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Nice To Haves

Utilization management and clinical experience preferred.
Supervisory and/or leadership experience strongly preferred.
RN compact license preferred.

Responsibilities

Supervises drafting and processing of correspondence in accordance with National Committee for Quality Assurance (NCQA) requirements
Supervises day-to-day activities and provides guidance to the team to ensure correspondence is reviewed and processed timely
Monitors and tracks all correspondence issues and researches to ensure documentation, processing, and resolution is in accordance with established policies and procedures
Provides expert knowledge and guidance based on experience to the correspondence team for issue resolution and processing to ensure compliance with state and National Committee for Quality Assurance (NCQA) requirements
Maintains knowledge of contract requirements, policies, procedures, and ensures correspondence team's compliance with contract requirements, policies, procedures, and performance standards
Works with team to identify opportunities for process and quality improvements within the denial processing and review process
Evaluates team performance and provides feedback regarding performance, goals, and career milestones
Provides coaching and guidance to team to ensure timely documentation for services and improve processing and quality of correspondence
Assists with onboarding, hiring, and training of team members
Leads and champions change within scope of responsibility
Performs other duties as assigned
Complies with all policies and standards