Supervisor, Operations (Claims)

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Position Purpose: The Supervisor Operations provides direct supervision to entry and/or processing staff and provides hiring, training, evaluation, development and performance management. Monitors and directs workflow to ensure timely and accurate processing to meet organizational objectives and contractual requirements. Develops policies and procedures to improve efficiencies and to support new contracts or programs. Interfaces with internal staff at all levels, field personnel, staff from other contractors and customers. Creates and monitors reports as required for process control and production effectiveness. Makes necessary adjustments to maintain quality standards and achieve operational goals. Completes special projects as required.

Applicants for this job have the flexibility to work remote from home and must reside in Florida.

• Ensures production effectiveness by monitoring reports, assigning resources as required, analyzing processes and making recommendations for process improvement

• Ensures quality effectiveness by monitoring reports and making adjustments to processes and procedures as necessary

• Responds to customer inquiries and tracks issues for possible process improvement

• Represents department with efforts to promote relationships, improve processes and secure goals

• Collects and analyzes operational data to determine reasons for calls and identify efficiency improvements

• Performs quality control work and provides feedback and coaching to staff

• Handles administrative issues (associate issues, disciplinary matters, timekeeping, scheduling)

• Handles escalations

• Works on special projects as required for staff or self-development as well as meeting corporate and departmental goals and objectives

• Works in conjunction with department staff to analyze and construct procedures in response to new programs or contracts

• Develops and maintains relationships with other departments to collaborate on issues and ensure optimum customer satisfaction

• Performs other duties as assigned

• Complies with all policies and standards

Education/Experience: Bachelor's Degree in a related field or equivalent work experience required. 2+ years direct supervisory experience including hiring and firing authority for minimum of ten associates required. 2+ years in healthcare (government healthcare delivery preferred) or production environment required. Claims processing, medical billing/coding experience strongly preferred. Knowledgeable in root cause and fee schedules highly preferred.
Government Security/Clearance/Citizenship Requirements: May require US citizenship and current security clearance

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act