Manager, Grievance & Appeals

Centene Corporation

. Ensure appropriate processing of member grievance appeals, provider appeals, and requests for a State Fair Hearing .

Posted 11/3/2026full-timeRemote • Arizona • United StatesMid-LevelSenior💰 $70,100 - $126,200 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing grievance and appeals processes within healthcare, ensuring compliance with federal and state laws. Proven ability to lead cross-functional teams, provide training, and deliver trend reporting to senior management.

Highest-signal resume keywords

Grievance And Appeals ManagementFederal And State Law KnowledgeSupervisory ExperienceCross-Functional Team LeadershipIncident Report Processing

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Grievance ProcessingAppeals ProcessingState Fair Hearing RequestsIncident Report ReviewContractual Compliance

Soft Skills

Problem SolvingCommunicationTraining And Direction

Industry Keywords

HealthcareLegal RequirementsRegulatory ComplianceTrend ReportingCommunity Engagement

About the role

Key responsibilities & impact

Ensure appropriate processing of member grievance appeals, provider appeals, and requests for a State Fair Hearing
Serve as the point of contact with the State
Manage the day-to-day responsibilities of Grievance & Appeals Coordinators
Ensure the department processes appeals and grievances within referred time frames and contractual/legal requirements
Monitor appeals and grievances and provide senior management with monthly trend reporting
Ensure member and provider grievances are processed and investigated according to contract requirements
Work with state, local and federal governments, local communities and the public on grievance and appeals matters
Integrate federal and state law changes into the company’s regulatory system
Recommend solutions and work with department and company staff to correct problems and prevent recurrences
Provide training and direction to agencies developing compliant procedures
Review and process incoming incident/accident reports

Requirements

What you’ll need

Candidate must live in Arizona
Bachelor’s degree in related field or equivalent experience
3+ 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
Supervisory experience including hiring, training, assigning work and managing staff performance
Ability to process grievances, appeals, State Fair Hearing requests, and incident/accident reports in accordance with contractual and legal requirements
Knowledge of federal and state law related to grievances and appeals
Ability to work with state, local and federal governments, local communities and the public

Benefits

Comp & perks

Competitive pay
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation
Benefits may be subject to program eligibility