Provider Engagement & Performance Manager

Centene Management Company LLC; Town of Texas (WI); Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Job summary

Centene is seeking a Provider Relations Manager to maintain partnerships between the health plan and contracted provider networks. You will build client relations to ensure delivery of high-quality care and drive performance improvements in cost utilization and quality outcomes.

Travel locally up to four days a week and educate providers on referrals and claims submission. The role requires a Bachelor’s degree and at least two years in managed care/provider relations, with proficiency in

Qualifications

• Bachelor’s degree or equivalent experience.
• Two years of managed care/provider relations/quality improvement/claims utilization management experience.
• Proficient in HEDIS/Quality measures, cost and utilization.

Responsibilities

• Serve as primary contact for providers and liaise between providers and the health plan.
• Triages provider issues for resolution with internal partners.
• Educate providers on policies and procedures related to referrals and claims submission.

Skills

Provider relations

Quality improvement

HEDIS/Quality measures

Project management

Education

Bachelor’s degree in related field or equivalent experience

Job description

Centene is seeking a Provider Relations Manager to maintain partnerships between the health plan and contracted provider networks. You will build client relations to ensure delivery of high-quality care and drive performance improvements in cost utilization and quality outcomes.

Travel locally up to four days a week and educate providers on referrals and claims submission. The role requires a Bachelor’s degree and at least two years in managed care/provider relations, with proficiency in