Provider Network Engagement Lead (Remote)

Centene Corp.; United States; Hybride; USD 56 000 - 101 000; Plein temps

Avantages offerts par ce poste

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Remote, hybrid, field or office work S

Résumé du poste

Centene Corp. in Ohio seeks a Provider Data and Relations specialist responsible for day-to-day duties ensuring providers are set up accurately in the provider information system for state reporting, claims payment, and directory listings.

The role covers managing provider networks, acting as liaison with physicians and groups, resolving data and contract issues, and supporting multiple state deliverables and internal operations to improve care access.

Qualifications

• Bachelor's degree or equal experience in healthcare.
• 5+ years of provider services or provider relations experience.
• Experience in a managed health care environment with provider contracting and benefits interpretation.

Responsabilités

• Act as internal and external liaison for provider networking within assigned area.
• Account management for assigned groups and gatekeeping interactions with internal departments.
• Oversee daily administration of provider relationships and training for providers.
• Research and resolve complex provider data and contract issues, including eligibility and language interpretation.
• Serve as primary contact between providers and the health plan; resolve claims/data issues.

Connaissances

Provider relations

Contract management

Data system literacy

Stakeholder communication

Formation

Bachelor's degree in healthcare related field or equivalent experience

Description du poste

Centene Corp. in Ohio seeks a Provider Data and Relations specialist responsible for day-to-day duties ensuring providers are set up accurately in the provider information system for state reporting, claims payment, and directory listings.

The role covers managing provider networks, acting as liaison with physicians and groups, resolving data and contract issues, and supporting multiple state deliverables and internal operations to improve care access.