Provider Engagement Specialist
4 days ago
Centene 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 liaison between our health plan and Tier III and Tier IV providers, managing network performance and driving provider performance improvement in key areas such as risk, quality, and cost. This role requires a strong consultative and account management approach, with a focus on evaluating provider performance and developing strategic plans to improve outcomes.
Key Responsibilities:- Manage network performance for assigned territory through a consultative/account management approach
- Drive provider performance improvement in key areas, including risk, quality, and cost
- Evaluate provider performance and develop strategic plans to improve outcomes
- Facilitate provider trainings, orientations, and coaching for performance improvement
- Serve as primary contact for providers and act as a liaison between providers and the health plan
- Triage provider issues for resolution to internal partners
- Investigate, resolve, and communicate provider claim issues and changes
- Initiate data entry of provider-related demographic information changes
- Educate providers on policies and procedures related to referrals and claims submission
- 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
Centene Corporation offers a comprehensive benefits package, including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off, 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. 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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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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