Serves as a liaison between providers, the health plan and Corporate to investigate and resolve provider claims.
Territory will be working with the Asian Market in Brooklyn, NY.
Conduct on-site provider orientations, including writing and updating orientation materials and assisting providers acclimated to plan website
Monitor financial performance of contracts
Investigate and document provider changes and correspondence
Coordinate with credentialing to ensure all appropriate documentation is received
Serve as a lead for key special projects
Recommend changes in pricing subsystems
Coordinate printing of provider directories with corporate and plan level entities
Investigate and respond to complex provider related issues and initiate change of provider related database information
Serve as a subject matter expert for provider relations activities and as a mentor for Provider Relations Specialist I staff
High school diploma or equivalent, required
Bachelor's degree in healthcare related field, preferred.
5 years of sales, provider relations, or contracting experience.
Claims processing and/or managed care experience preferred.
Valid driver's license, required
Flexibility to travel throughout an assigned area, required
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.