Senior Remote Provider Network & Relations Specialist

Centene Corporation; Ohio; On-site; USD 56,000 - 101,000; Full time

Job summary

Centene Corporation in Ohio is seeking a provider services professional to ensure accurate provider setup in information systems for state reporting, claims payment, and directories. The role includes liaison with providers, contract loading support, and resolving data issues within a managed care environment.

The ideal candidate has a Bachelor’s degree in a healthcare field and 5+ years of provider services experience, with the ability to communicate across departments and resolve complex

Qualifications

• Bachelor’s degree in healthcare field or equivalent experience.
• 5+ years of provider services experience in managed care.
• Experience with provider contracting, benefits interpretation, and provider relations operations.

Responsibilities

• Act as liaison for provider networking with physicians, groups, and ancillary providers.
• Manage assigned provider relationships and serve as gatekeeper for internal departments.
• Oversee accurate and current provider databases and provide training to providers.
• Research and resolve complex issues around contracts, financial responsibility, and language interpretation.
• Serve as primary contact between providers and Centene health plan.
• Provide issue resolution support for complex provider contracts and data issues.
• Act as department subject matter expert and perform additional duties as assigned.
• Comply with all policies and standards.

Skills

Provider relations

Contract interpretation

Data issue resolution

Liaison/communication

Education

Bachelor’s degree in healthcare related field

Job description

Centene Corporation in Ohio is seeking a provider services professional to ensure accurate provider setup in information systems for state reporting, claims payment, and directories. The role includes liaison with providers, contract loading support, and resolving data issues within a managed care environment.

The ideal candidate has a Bachelor’s degree in a healthcare field and 5+ years of provider services experience, with the ability to communicate across departments and resolve complex