Supervisor, Provider Network

Centene Corporation; United States; 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 plus holidays

Flexible work arrangements

Job summary

Centene Corporation is seeking a Network Accounts Supervisor to oversee the network accounts department nationwide. You will supervise daily workflow, support provider contracting, and respond to escalated issues to ensure compliance with health plan policies.

With a Bachelor’s degree and 3+ years in network account management or related billing in managed care, you will help maintain policy manuals, coordinate trainings, and drive quality initiatives across projects.

Qualifications

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

Responsibilities

• Supervise 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

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

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.

Centene offers a comprehensive benefits package including:

• 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.

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