Provider Engagement Specialist

4 weeks ago


Nashville, Tennessee, United States Centene Corporation Full time
Job Title: Provider Engagement Administrator

We are seeking a highly skilled Provider Engagement Administrator to join our team at Centene Corporation. As a key member of our organization, you will play a critical role in driving provider performance improvement and ensuring the success of our healthcare initiatives.

Key Responsibilities:
  • Act as a liaison between Tier III and Tier IV providers and the health plan, facilitating effective communication and collaboration.
  • Manage Network performance for assigned territory through a consultative/account management approach, driving provider performance improvement in key areas such as Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost, and utilization.
  • Evaluate provider performance and develop strategic plans to improve performance, including detailed HBR analysis and provider trainings, orientations, and coaching.
  • Serve as primary contact for providers, acting as a liaison between the providers and the health plan, and triaging provider issues as needed for resolution to internal partners.
  • Investigate, resolve, and communicate provider claim issues and changes, and initiate data entry of provider-related demographic information changes.
  • Educate providers regarding policies and procedures related to referrals and claims submission, website usage, EDI solicitation, and related topics, and perform provider orientations and ongoing provider education.
Requirements:
  • Bachelor's degree in a related field or equivalent experience.
  • 0-2 years of provider relations, provider claims/reimbursement, or contracting experience.
  • Knowledge of healthcare, managed care, Medicare, or Medicaid.
  • Claims billing/coding knowledge preferred.
  • Behavioral health experience strongly preferred.
What We Offer:

Centene offers a comprehensive benefits package, including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and 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. Total compensation may also include additional forms of incentives.

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



  • Nashville, Tennessee, United States Level Eight LLC Full time

    Job DescriptionJob Title: Customer Engagement SpecialistCompany: Level Eight LLCJob Type: Full-timeLocation: RemoteJob Description:We are seeking a highly motivated and results-driven Customer Engagement Specialist to join our team. As a Customer Engagement Specialist, you will be responsible for engaging with our online customers to understand their needs...


  • Nashville, Tennessee, United States MPLOY Full time

    Job Title: Channel Engagement SpecialistAt MPLOY, we're seeking a skilled Channel Engagement Specialist to join our team. As a key member of our Channel Engagement Team, you will play a crucial role in leading media and web tagging, tracking, analytics audits, and implementation, data connections, reporting, and insight identification.Key...


  • Nashville, Tennessee, United States Meharry Medical College Full time

    Job Title: Digital Engagement SpecialistMeharry Medical College is seeking a highly skilled Digital Engagement Specialist to join our team. As a key member of our communications department, you will play a critical role in developing and implementing our digital communications strategy.Key Responsibilities:Develop and implement an annual digital...


  • Nashville, Tennessee, United States HealthStream Full time

    Job Title: Customer Engagement SpecialistJob Summary:We are seeking a highly skilled Customer Engagement Specialist to join our team at HealthStream. As a key member of our customer success team, you will be responsible for ensuring seamless customer onboarding and adoption of our healthcare solutions.Key Responsibilities:Provide consultative support to...


  • Nashville, Tennessee, United States HealthStream Full time

    Job DetailsDescriptionHealthStream is a leading provider of healthcare workforce solutions, empowering organizations to work better by helping their people work smarter. As a Customer Engagement Specialist, you will play a critical role in supporting customers in transitioning from the post-sales process through onboarding and into full product adoption.Key...


  • Nashville, Tennessee, United States Heidelberg Materials US, Inc. Full time

    Job SummaryWe are seeking a highly skilled Community Outreach Specialist to join our team at Heidelberg Materials US, Inc. in Mitchell, Indiana or Indianapolis, Indiana. This role will be responsible for developing and implementing community benefit programs that align with the DOE project requirements and supporting the overall company approach in community...


  • Nashville, Tennessee, United States MPLOY Full time

    Job Title: Channel Engagement AnalystAt MPLOY, we're seeking a skilled Channel Engagement Analyst to join our team. As a key member of our Channel Engagement Team, you will play a crucial role in leading media and web tagging, tracking, analytics audits, and implementation, data connections, reporting, and insight identification.Key Responsibilities:Analyze...


  • Nashville, Tennessee, United States Heidelberg Materials US, Inc. Full time

    Job SummaryThe Community Outreach Specialist will be responsible for developing, implementing, and managing community benefits programs that align with the DOE project requirements. This role involves collaborating with various stakeholders, including community organizations, government agencies, and internal departments, to ensure the successful delivery of...


  • Nashville, Tennessee, United States Heidelberg Materials US, Inc. Full time

    {"Program Development": "Develop and implement community benefit programs that align with the DOE project requirements and support the company's approach to community engagement. This involves designing and delivering programs that address the needs of the community and foster collaboration and support for community benefit initiatives.", "Stakeholder...


  • Nashville, Tennessee, United States Meharry Medical College Full time

    About the RoleMeharry Medical College is seeking a highly skilled Digital Engagement & Web Development Coordinator to support the College's communications efforts through the strategic engagement of various audiences across multiple channels and campaigns.Key ResponsibilitiesDevelop and implement an annual digital communications plan to increase brand...


  • Nashville, Tennessee, United States Novalink Solutions Full time

    Job Title: Community Outreach WorkerWe are seeking a highly skilled Community Outreach Worker to join our team at Novalink Solutions. This role will act as a liaison between public health departments and local communities, fostering stronger partnerships and facilitating effective communication.Key Responsibilities:Establish and maintain relationships with...


  • Nashville, Tennessee, United States The Patient Engagement Center Full time

    Job OverviewWe are seeking a highly motivated and empathetic Medical Customer Experience Representative to join our dynamic team at the Patient Engagement Center of Excellence. As a key member of our team, you will play a vital role in engaging patients suffering from Painful Diabetic Neuropathy and scheduling them for treatment at our medical practice...


  • Nashville, Tennessee, United States Novalink Solutions LLC Full time

    Job SummaryWe are seeking a highly skilled Community Outreach Worker to join our team at Novalink Solutions LLC. This role will serve as a liaison between public health departments and local communities, fostering stronger partnerships and promoting health awareness.Key ResponsibilitiesEstablish and maintain relationships with community members and...


  • Nashville, Tennessee, United States Broadcast Music Full time

    POSITION OVERVIEWThe Affiliate Customer Service Associate is dedicated to delivering outstanding support to our songwriter and publisher clientele. This role is essential in fostering customer satisfaction by effectively addressing inquiries, resolving challenges, and providing assistance with professionalism and empathy.WORK ENVIRONMENTThis position is...


  • Nashville, Tennessee, United States Careers Integrated Resources Inc Full time

    Job Title: Community Outreach WorkerJob Summary:We are seeking a highly skilled Community Outreach Worker to join our team at Careers Integrated Resources Inc. This role will serve as a liaison between public health departments and local communities, fostering strong relationships and promoting education and community service work.Key...


  • Nashville, Tennessee, United States LEAD Public Schools Full time

    Job Title: Family Engagement AssociateLEAD Public Schools is seeking a highly motivated and organized Family Engagement Associate to join our team. As a key member of our Network Engagement Team, you will play a critical role in supporting the recruitment, enrollment, and family engagement efforts for our network of campuses.Key Responsibilities:Support the...


  • Nashville, Tennessee, United States LEAD Public Schools Full time

    Job SummaryWe are seeking a highly motivated and organized Family Engagement Associate to join our team at LEAD Public Schools. This role will play a critical part in supporting the recruitment, enrollment, and family engagement efforts for our network of campuses.Key ResponsibilitiesSupport the on-going recruitment, enrollment, and family engagement efforts...


  • Nashville, Tennessee, United States HomeGoods Full time

    Job Title: Engagement CoordinatorAt HomeGoods, we're always looking for talented individuals to join our team. As an Engagement Coordinator, you'll play a key role in promoting a highly satisfied customer experience while driving customer loyalty.Key Responsibilities:Promote a highly satisfied customer experience through excellent customer service...


  • Nashville, Tennessee, United States Genentech, Inc Full time

    Job Title: Business Engagement ManagerGenentech, Inc. is seeking a highly skilled Business Engagement Manager to join our team. As a Business Engagement Manager, you will play a critical role in connecting with customers, including large provider institutions, and internal stakeholders to drive business growth and patient access.Key Responsibilities:Develop...


  • Nashville, Tennessee, United States Norstella Full time

    About the RoleWe are seeking a highly skilled Strategic Engagement Director to lead our client projects and drive business growth.As a key member of our team, you will be responsible for managing multiple workstreams, creating client-ready deliverables, and developing strategic plans to meet client objectives.You will work closely with our clients to...