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 : Serve as a liaison between providers, the health plan and Corporate to investigate and resolve provider claims
- Responsible for covering Provider Relations and willing to drive to Broome, Chenango, and Tioga counties
- Conduct on-site provider orientations, including writing and updating orientation materials and assisting providers acclimated to plan website
- Monitor financial performance of contracts
- Investigate and document provider changes and correspondence
- Coordinate with credentialing to ensure all appropriate documentation is received
- Serve as a lead for key special projects
- Recommend changes in pricing subsystems
- Coordinate printing of provider directories with corporate and plan level entities
- Investigate and respond to complex provider related issues and initiate change of provider related database information
- Serve as a subject matter expert for provider relations activities and as a mentor for Provider Relations Specialist I staff
- Ability to travel
Education / Experience : High school diploma or equivalent. Bachelor’s degree in healthcare related field preferred. 5+ years of sales, provider relations, or contracting experience.
Claims processing and / or managed care experience preferred. Driver’s License may be required by some plans. Specific language skills may be required by some plans.
License / Certification : Valid driver's license.
For Fidelis Care only : Must have valid driver license, personal vehicle and ability to travel.Pay Range : $54,000.00 - $97,100.00 per year
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.
Total compensation may also include additional forms of incentives.
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