Provider Engagement Specialist II
8 hours ago
Centene Corporation is seeking a highly skilled Provider Engagement Administrator II to join our team. As a key member of our organization, you will play a critical role in building and maintaining strong relationships with healthcare providers, driving network performance improvement, and ensuring seamless communication between providers and our health plan.
Key Responsibilities:- Act as a liaison between Tier II providers and the health plan, managing network performance for assigned territory through a consultative/account management approach.
- Drive provider performance improvement in areas such as risk/P4Q, health benefit ratio (HBR), HEDIS/quality, cost, and utilization.
- Evaluate provider performance and develop strategic plans to improve performance.
- Perform 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.
- Coach new and less experienced External Reps.
- Complete special projects as assigned.
- 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.
- 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.
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Provider Engagement Specialist
2 weeks ago
Harrisburg, Pennsylvania, United States Centene Corporation Full time{"title": "Provider Engagement Specialist", "content": "Job SummaryCentene Corporation is seeking a skilled Provider Engagement Specialist to join our team. As a key member of our healthcare network, you will play a critical role in building and maintaining strong relationships with our provider partners.Key Responsibilities Serve as primary contact for...
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Provider Engagement Specialist
1 week ago
Harrisburg, Pennsylvania, United States Centene Corporation Full timeJob Title: Provider Engagement AdministratorCentene Corporation is seeking a highly skilled Provider Engagement Administrator to join our team. As a key member of our organization, you will play a critical role in building and maintaining strong relationships with our healthcare providers.Job Summary:The Provider Engagement Administrator will serve as a...
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Provider Engagement Specialist
18 hours ago
Harrisburg, Pennsylvania, United States Centene Corporation Full timeJob Title: Provider Engagement AdministratorCentene Corporation is seeking a highly skilled Provider Engagement Administrator to join our team. As a key member of our organization, you will play a critical role in building and maintaining strong relationships with our healthcare providers.Job Summary:The Provider Engagement Administrator will serve as a...
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