Remote Provider Network & Data Specialist (NJ)

Centene Corporation; United States; Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Job summary

Centene Corporation is seeking a Provider Relations professional to manage provider data and relationships across the NJ area. The role involves acting as liaison between providers and the health plan, resolving complex contract and data issues, and collaborating with internal teams to ensure accurate directory and claims processing.

The ideal candidate has a healthcare background with 5+ years in provider services, including contracting and benefits interpretation, and must reside in New

Qualifications

• Bachelor's degree in healthcare related field is required.
• 5+ years of provider services experience required in managed care.
• Experience with provider contracting, benefits interpretation, and provider relations operations.

Responsibilities

• Maintain accurate provider databases and manage daily provider relationships.
• Provide training and information to providers and external representatives.
• Serve as liaison between providers and health plan and coordinate across internal departments.
• Investigate and resolve complex problems related to contract loading and financial responsibilities.
• resolve provider data issues and provider claims inquiries in collaboration with relevant teams.
• Act as subject matter expert and support other team members as needed.

Skills

Provider relations

Contract loading

Data issue resolution

Stakeholder communication

Education

Bachelor's degree in healthcare related field

Tools

CRM systems

Job description

Centene Corporation is seeking a Provider Relations professional to manage provider data and relationships across the NJ area. The role involves acting as liaison between providers and the health plan, resolving complex contract and data issues, and collaborating with internal teams to ensure accurate directory and claims processing.

The ideal candidate has a healthcare background with 5+ years in provider services, including contracting and benefits interpretation, and must reside in New