Provider Relations Specialist II- Brooklyn (Mandarin/Cantonese)

Centene Corporation Rego Park , NY 11374

Posted 2 months ago

Position Purpose:

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.

Responsibilities:

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

Education/Experience:

  • 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.


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Provider Relations Specialist II- Brooklyn (Mandarin/Cantonese)

Centene Corporation