Healthcare Liaison

1 month ago


Miami, Florida, United States Centene Corporation Full time
Job Summary

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
Requirements

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 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.



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