Remote Provider Network & Contracts Lead

Centene Corporation; Trenton (NJ); On-site; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work with remote/hybrid/field

Job summary

Centene Corporation is hiring for a Provider Services role covering NJ, requiring residency in-state. The position oversees provider data setup, contract loading, and network relations within a managed care context.

It includes liaison duties with physicians and groups, and resolving complex provider data issues. Ideal candidates have a healthcare bachelor’s degree and 5+ years in provider services, with strong relationship-building and problem-solving skills.

Qualifications

• Bachelor's degree in healthcare field or equivalent experience required.
• 5+ years of provider services experience in managed health care environments.
• Experience with provider contracting, servicing benefits interpretation, and provider relations operations may be required.

Responsibilities

• Act as internal and external liaison for provider networking with physicians, PPGs, multi-specialty groups, and ancillary providers.
• Serve as account manager for assigned groups and gatekeeper for interactions with internal departments.
• Manage daily administration and operation of contractual provider relationships and provider databases; provide training and information to providers.
• Research, analyze and resolve complex problems related to contract loading, financial responsibilities, contract language, appeals and eligibility.
• Be the primary point of contact between providers and the health plan; support complex provider contracts by coordinating resolution of claims and data issues.
• Act as department subject matter expert and perform other duties as assigned; comply with policies and standards.

Skills

Provider services experience

Account management

Provider relations liaison

Data issue resolution

Education

Bachelor's degree in healthcare related field

Job description

Centene Corporation is hiring for a Provider Services role covering NJ, requiring residency in-state. The position oversees provider data setup, contract loading, and network relations within a managed care context.

It includes liaison duties with physicians and groups, and resolving complex provider data issues. Ideal candidates have a healthcare bachelor’s degree and 5+ years in provider services, with strong relationship-building and problem-solving skills.