Position Purpose: Perform initial health plan orientation and conduct ongoing educational outreach with a focus on improving quality and financial outcomes within provider network
Conduct initial provider orientations as well as ongoing educational outreach
Educate providers regarding policies and procedures related to referrals, claims submission, web site education, Electronic Health Records, Health Information Exchange, and Electronic Data Interface
Engage providers on Patient Centered Medical Home initiatives
Perform detailed HBR (Health Benefits Ratio) analysis and create reports for provider Review provider performance by both quantitative metrics and qualitative factors
Create and communicate milestone documents, dashboards and success metrics
Act as a liaison between the provider and the health plan ensuring a coordinated effort in improving financial and quality performance
Provide status updates for providers regarding incentive agreements
Conduct site visits when required and other Contracting duties as requested
Ability to travel
Education/Experience: Bachelor's Degree in related field or equivalent experience. 3 years of combined managed healthcare and provider reimbursement experience.
Advanced knowledge of Microsoft Excel. Clinical or health information management (HIM) experience preferred.
Current state driver's license.
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.