Supervisor, Provider Network

Centene Management Company LLC; Town of Texas (WI); Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Remote, hybrid, field or office work

Job summary

Centene is seeking a Network Accounts Supervisor to supervise the day-to-day operations of the network accounts department and ensure compliance with health plan and state policies. The role includes coordinating contracting activities, responding to escalated issues and maintaining provider manuals, with opportunities to lead quality initiatives and staff training.

Qualified candidates will have a Bachelor’s degree or equivalent, 3+ years in network accounts or related fields, and supervisory

Qualifications

• Bachelor’s degree or equivalent experience.
• 3+ years of network account management, provider contracting or billing experience in a managed care environment.
• Supervisory or lead experience preferred. Knowledge of managed care and state Medicaid program guidelines.

Responsibilities

• Supervise the day-to-day workflow of the network accounts function.
• Assist with provider contracting activities to minimize contract issues/errors.
• Review and audit network accounts documentation for compliance with health plan and state standards.
• Plan, coordinate and participate in meetings with network account representatives to conduct orientations, train on health plan policies and procedures.
• Analyze, develop, implement and monitor quality initiatives to achieve healthy outcomes for assigned projects.
• Coordinate and host health plan-sponsored events held for network account representatives.
• Assist in the development of policies and procedures and update and maintain the Provider Manuals.

Education

Bachelor’s degree or equivalent experience

Job description

Position Purpose

Supervise and coordinate the operations of the network accounts department

Key Details

This position is open nationwide. Supervise the day-to-day workflow of the network accounts function in compliance with health plan, corporate and state policies, procedures and guidelines Assist with provider contracting activities to minimize contract implementation issues/errors Receive and respond to all escalated provider issues and ensure standards are established, met and maintained Plan, coordinate and participate in scheduled and unscheduled meetings with network account representatives to conduct orientations, train on health plan policies and procedures, deliver materials or inquire about contracting with our health plan Review and audit network accounts documentation for compliance with health plan and State standards Analyze, develop, implement and monitor quality initiatives to achieve healthy outcomes for assigned projects Assist in the resolution of claims payment and provider systems set-up issues Coordinate and host health plan-sponsored events held for network account representatives Assist in the development of policies and procedures and update and maintain the Provider Manuals

Education/Experience

Bachelor’s degree or equivalent experience. 3+ years of network account management, provider contracting or billing experience in a managed care environment. Supervisory or lead experience preferred. Knowledge of managed care and state Medicaid program guidelines.

Pay Range

$56,200.00 - $101,000.00 per year

About Centene

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• a flexible approach to work with remote, hybrid, field or office work schedules

Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Equal Opportunity

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.

Centene is committed to helping people live healthier lives. We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.