Provider Partnership Associate

Oklahoma Complete Health; New York (NY); On-site; USD 55,000 - 99,000; Full time

Job summary

An established industry player is seeking a Provider Partnership Associate to enhance the quality and financial outcomes within their provider network. This role involves conducting provider orientations, educating them on essential policies and procedures, and analyzing performance metrics. You will act as a vital liaison between providers and the health plan, ensuring improved financial and quality performance. With a comprehensive benefits package and a focus on workplace flexibility, this is an exciting opportunity to make a significant impact in the healthcare sector.

Benefits

Health Insurance

401K

Stock Purchase Plans

Tuition Reimbursement

Paid Time Off

Flexible Work Arrangements

Qualifications

• 3+ years of experience in managed healthcare and provider reimbursement.
• Advanced knowledge of Microsoft Excel required.

Responsibilities

• Conduct initial provider orientations and ongoing educational outreach.
• Engage providers on Patient Centered Medical Home initiatives.
• Review provider performance using quantitative and qualitative metrics.

Skills

Managed Healthcare Experience

Provider Reimbursement Experience

Microsoft Excel

Health Information Management

Education

Bachelor’s Degree in a related field

Job description

Provider Partnership Associate

Apply locations

• Long Island City Satellite Office - 27-01 Bridge Plaza North (10812)
• New York - One New York Plaza (11040)
• Rego Park - New York City Regional Office - 95-25 Queens Blvd (10815)

Position Type: Full time

Posted: Yesterday

Requisition ID: 1561144

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:

Perform initial health plan orientation and conduct ongoing educational outreach with a focus on improving quality and financial outcomes within provider network.

Responsibilities:

• Conduct initial provider orientations and ongoing educational outreach.
• Educate providers regarding policies and procedures related to referrals, claims submission, website education, Electronic Health Records, Health Information Exchange, and Electronic Data Interface.
• Engage providers on Patient Centered Medical Home initiatives.
• Perform detailed HBR (Health Benefits Ratio) analysis and create reports for providers.
• Review provider performance using both quantitative metrics and qualitative factors.
• Create and communicate milestone documents, dashboards, and success metrics.
• Act as a liaison between providers and the health plan to improve financial and quality performance.
• Provide status updates regarding incentive agreements.
• Conduct site visits when required and perform other contracting duties as requested.
• Ability to travel as needed.

Education and Experience:

Bachelor’s Degree in a related field or equivalent experience. At least 3 years of managed healthcare and provider reimbursement experience. Advanced knowledge of Microsoft Excel. Clinical or health information management (HIM) experience preferred. Current state driver’s license.

Note for Fidelis Care: Must have a valid driver’s license, personal vehicle, and ability to travel. Pay Range: $55,100 - $99,000 per year.

Benefits:

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off plus holidays, and flexible work arrangements (remote, hybrid, field, or office schedules). Actual pay will be adjusted based on skills, experience, education, and other factors. Total compensation may include additional incentives.

Equal Opportunity Employer:

Centene is committed to diversity and values differences. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics by law.

Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws.