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Provider Engagement Specialist

2 months ago

Baton Rouge, Louisiana, United States Centene Corporation Full time
{"title": "Provider Engagement Administrator II", "description": "Transforming Healthcare Together

At Centene Corporation, we're committed to transforming the health of our communities, one person at a time. As a Provider Engagement Administrator II, you'll play a critical role in driving provider performance improvement and ensuring seamless interactions between our health plan and Tier II providers.

Key Responsibilities:
  • Manage network performance for assigned territory through a consultative/account management approach
  • Evaluate provider performance and develop strategic plans to improve performance
  • Drive provider performance improvement in areas such as Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost, and utilization
  • Present detailed HBR analysis and create reports for Joint Operating Committee meetings (JOC)
  • Develop proficiency in tools and value-based performance (VBP) and educate providers on use of tools and interpretation of data
Requirements:
  • Bachelor's degree in related field or equivalent experience
  • Three years of provider relations, provider claims/reimbursement, or contracting experience
  • Knowledge of healthcare, managed care, Medicare, or Medicaid
What We Offer:
  • Competitive pay and benefits package
  • Opportunities for professional growth and development
  • A dynamic and supportive work environment

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.

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