Healthcare Liaison
1 month ago
We are seeking a skilled Healthcare Liaison to join our team at Centene Corporation. As a key member of our organization, you will serve as the primary contact for providers and act as a liaison between the providers and our health plan.
Key Responsibilities- Serve as primary contact for providers and act as a liaison between the providers and the health plan
- Triage provider issues as needed for resolution to internal partners
- Receive and effectively respond to external provider-related issues
- Investigate, resolve, and communicate provider claim issues and changes
- 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
- Perform provider orientations and ongoing provider education, including writing and updating orientation materials
- 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, HBR, HEDIS/quality, cost, and utilization
- Complete special projects as assigned
- Ability to travel locally 4 days a week
- Perform other duties as assigned
We are looking for a candidate with a Bachelor's degree in a related field or equivalent experience. 0-2 years of provider relations, provider claims/reimbursement, or contracting experience is preferred. Knowledge of healthcare, managed care, Medicare, or Medicaid is also preferred. Claims billing/coding knowledge is a plus.
What We OfferCentene 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.
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