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Centene Corporation in the United States is seeking a provider liaison to serve as a bridge between providers, the health plan, and corporate teams. The role focuses on resolving pharmacy-related claims issues and educating physician practices on policies and procedures.
Responsibilities include monthly on-site meetings with providers, weekly collaboration with Case Management, provider orientations, and travel as needed.
Perform duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider physician injectable claims issues. Perform training, orientation and coaching for performance improvement within physician practices. 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.
Serve as primary contact for providers serving as a liaison between the provider and the health plan for all pharmacy concerns.
Conduct monthly face to face meetings with the providers documenting discussions, issues, attendees, and action items researching claims issues on-site and routing to the appropriate party for resolution.
Attend weekly meetings with Case Management to assist where needed with pharmacy or medication concerns.
Educate providers regarding policies and procedures related to pharmacy issues; web site education, and problem solving (liaison responsibilities).
Perform Provider orientations (includes writing/updating orientation material when necessary).
Must have a good driving record and the ability to travel.
Complies with all policies and standards.
Bachelor’s degree in Healthcare related field preferred. 3+ years of combined public relations and pharmacy related experience. Claims billing/coding knowledge preferred.
Pay Range: $27.02 - $48.55 per hour
You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including:
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.
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.