Senior Provider Relations & Network Engagement Lead

Centene Management Company LLC

Ohio

Hybride

USD 56 000 - 101 000

Plein temps

Il y a 5 jours

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Avantages offerts par ce poste

Benefits package

Flexible work arrangements

Résumé du poste

Centene Management Company LLC is seeking an experienced Provider Data and Provider Relations specialist in Ohio to ensure accurate setup in the provider information system for state reporting, directories, and claims payment. You will advise external provider reps, manage provider databases, and act as primary liaison for complex contract questions.

The role requires a Bachelor’s degree in healthcare or related field and at least 5 years in provider services within managed care, with strong

Qualifications

Bachelor’s degree in healthcare-related field or equivalent experience.
5+ years of provider services experience in a managed care environment with exposure to contracting, servicing benefits interpretation, and internal operations.

Responsabilités

Ensure provider data accuracy in the provider information system for state reporting, claims payment, and directories.
Provide support to external provider representatives to resolve provider data issues and respond to related inquiries.
Manage daily administration and operation of contractual provider relationships and provider databases.
Research, analyze and resolve complex problems involving contracts, payments, and eligibility; act as SME.