Remote Provider Performance & Engagement Specialist

Centene Corp.; New York (NY); Hybride; USD 56 000 - 101 000; Plein temps

Résumé du poste

Centene Corp. is seeking a Provider Performance Specialist II to remotely support the New York area. You will analyze performance data, discuss results with providers, and collaborate with quality teams to drive better member outcomes.

The role emphasizes proficiency with VBP tools, presenting HBR analyses, and preparing executive reports. Ideal candidates hold a bachelor’s degree or equivalent experience and have 2+ years in managed care or provider reimbursement, with a preference for claims

Qualifications

• Bachelor’s degree in related field or equivalent experience.
• 2+ years of combined managed healthcare and provider reimbursement experience.
• Claims processing and/or managed care experience preferred.

Responsabilités

• Interpret performance data, prioritizing insights and developing discussion and presentation documents.
• Facilitate provider discussions regarding quality, utilization, and cost or risk performance improvement opportunities.
• Collaborate with health plan quality counterpart to ensure coordinated communication and goal alignment for provider discussions.
• Develop proficiency in tools and value based performance (VBP) and educate providers on the use of tools and interpretation of data.
• Present detailed HBR (Health Benefits Ratio) analysis and create reports for Joint Operating Committee meetings.
• Performs other duties as assigned and complies with all policies and standards.

Connaissances

Provider analytics

Presentation to stakeholders

Data interpretation

Formation

Bachelor’s degree in related field or equivalent experience

Description du poste

Centene Corp. is seeking a Provider Performance Specialist II to remotely support the New York area. You will analyze performance data, discuss results with providers, and collaborate with quality teams to drive better member outcomes.

The role emphasizes proficiency with VBP tools, presenting HBR analyses, and preparing executive reports. Ideal candidates hold a bachelor’s degree or equivalent experience and have 2+ years in managed care or provider reimbursement, with a preference for claims