Senior NJ Provider Relations & Network Engagement Lead

Centene Management Company LLC; New Jersey; Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health Insurance

401K and Stock Purchase Plans

Tuition Reimbursement

Paid time off plus holidays

Remote, Hybrid, Field or Office work

Job summary

Centene Management Company LLC in New Jersey seeks a Provider Data Specialist to ensure accurate provider setup in the provider information system for state reporting, claims payment, and directories. You will support external provider representatives and resolve provider data issues.

The role requires a Bachelor's degree in a healthcare-related field or equivalent experience, plus 5+ years in provider services within a managed care environment.

Qualifications

• Bachelor’s degree in healthcare-related field or equivalent experience.
• 5+ years of provider services experience in a managed health care environment.
• Experience with provider contracting and benefits interpretation.

Responsibilities

• Set up providers in the provider information system for state reporting, claims payment and directories.
• Serve as liaison between providers and the health plan; resolve provider data issues.
• Train and support external provider representatives; oversee provider databases and relationships.

Skills

Provider relations

Healthcare industry

Contract interpretation

Data issue resolution

Education

Bachelor's degree in healthcare field

Job description

Centene Management Company LLC in New Jersey seeks a Provider Data Specialist to ensure accurate provider setup in the provider information system for state reporting, claims payment, and directories. You will support external provider representatives and resolve provider data issues.

The role requires a Bachelor's degree in a healthcare-related field or equivalent experience, plus 5+ years in provider services within a managed care environment.