Remote Senior Provider Network & Engagement Specialist

Centene Corporation; Pennsylvania; À distance; USD 56 000 - 101 000; Plein temps

Avantages offerts par ce poste

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work with remote, hybrid, or/

Résumé du poste

Centene is seeking a Provider Relations professional to ensure accurate provider setup in systems and to deliver on state reporting, network reporting, and directories. You will support provider representatives, manage day-to-day provider relationships, and resolve complex data and contract issues.

The role requires a Bachelor’s degree in a healthcare-related field and 5+ years in provider services, with remote work in Western/Southwestern Pennsylvania and periodic travel.

Qualifications

• Bachelor’s degree or equivalent experience required.
• 5+ years of provider services experience in a managed care environment.
• Experience with provider contracting and provider data/claims systems preferred.

Responsabilités

• Act as internal and external liaison for provider networking and provider relations.
• Serve as account manager for assigned groups and gatekeeper for interactions with internal departments.
• Oversee daily administration of provider relationships and maintain accurate provider databases.
• Research, analyze and resolve complex provider contract data, rate language and eligibility issues.
• Provide issue resolution support for provider data and claims issues; act as SME.

Connaissances

Provider relations

Account management

Liaison

Training providers

Issue resolution

Formation

Bachelor's degree in healthcare related field

Description du poste

Centene is seeking a Provider Relations professional to ensure accurate provider setup in systems and to deliver on state reporting, network reporting, and directories. You will support provider representatives, manage day-to-day provider relationships, and resolve complex data and contract issues.

The role requires a Bachelor’s degree in a healthcare-related field and 5+ years in provider services, with remote work in Western/Southwestern Pennsylvania and periodic travel.