Provider Partnership Associate

Centene Corporation; New York (NY); Remote; USD 55,000 - 99,000; Full time

Job summary

An established industry player is seeking a dedicated professional to enhance the quality and financial outcomes within their provider network. This role involves conducting educational outreach, analyzing provider performance, and ensuring compliance with policies. The ideal candidate will have a strong background in managed healthcare, excellent communication skills, and the ability to engage effectively with providers. With a focus on flexibility and work-life balance, this position offers a competitive salary and comprehensive benefits, including health insurance and tuition reimbursement. Join a team committed to transforming health in communities across the nation.

Benefits

Health Insurance

401K Plan

Stock Purchase Plans

Tuition Reimbursement

Paid Time Off

Flexible Work Arrangements

Qualifications

• 3+ years of experience in managed healthcare and provider reimbursement.
• Clinical or health information management experience preferred.

Responsibilities

• Conduct provider orientations and ongoing educational outreach.
• Perform Health Benefits Ratio analysis and create reports for providers.
• Act as a liaison between providers and the health plan.

Skills

Managed Healthcare

Provider Reimbursement

Health Information Management

Data Analysis

Communication Skills

Education

Bachelor's Degree in a related field

Job description

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 the provider network.

Responsibilities:

1. Conduct initial provider orientations as well as ongoing educational outreach.
2. Educate providers regarding policies and procedures related to referrals, claims submission, website education, Electronic Health Records, Health Information Exchange, and Electronic Data Interface.
3. Engage providers on Patient Centered Medical Home initiatives.
4. Perform detailed Health Benefits Ratio (HBR) analysis and create reports for providers. Review provider performance using both quantitative metrics and qualitative factors.
5. Create and communicate milestone documents, dashboards, and success metrics.
6. Act as a liaison between providers and the health plan to ensure coordinated efforts in improving financial and quality performance.
7. Provide status updates for providers regarding incentive agreements.
8. Conduct site visits as required and perform other contracting duties as requested.
9. Travel as needed.
10. Perform other duties as assigned and ensure compliance with all policies and standards.

Education and Experience:

Bachelor’s Degree in a related field or equivalent experience. 3+ years of combined managed healthcare and provider reimbursement experience. Clinical or health information management (HIM) experience preferred. A valid state driver’s license is required.

For Fidelis Care only: Must have a valid driver’s license, personal vehicle, and ability to travel.

Additional Information:

Candidates must reside in the downstate New York/New York City area. This role is remote/field-based, requiring approximately 50% travel locally to meet with providers.

Compensation and Benefits:

Pay Range: $55,100.00 - $99,000.00 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 flexible work arrangements (remote, hybrid, field, or office schedules). Actual pay will depend on skills, experience, education, and other factors. Total compensation may include additional incentives.

Equal Opportunity Employment:

Centene is an equal opportunity employer committed to diversity. All qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics. Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws such as the LA County Ordinance and the California Fair Chance Act.