You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
***NOTE: We are seeking candidates who live near Kansas City, KS for this role***
Position Purpose: Acts as a liaison between Tier I providers (hospital systems, large multi-specialty groups, providers on value-based contracts and/or those with complex contracts) and the health plan. Manages Network performance for assigned territory through a consultative/account management approach. Drives provider performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc. Evaluates provider performance and develops strategic plan to improve performance. Performs detailed HBR analysis. Facilitates provider trainings, orientations, and coaches for performance improvement within the network and assists with claim resolution.
Education/Experience: Bachelor’s degree in related field or equivalent experience. Five + years of combined provider relations, provider claims/reimbursement, or contracting experience. Knowledge of health care, managed care, Medicare or Medicaid. Bachelor’s degree in healthcare or a related field preferred. Claims billing/coding knowledge preferred.
For Sunflower Health Plan: Must have prior customer service experience and insurance Claim experience with training in billing. Pay Range: $67,400.00 - $121,300.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, 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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
...WE WANT YOU IF . . . - You are friendly and outgoing - You are honest - You like to be the BEST at whatever you do No experience necessary, we will train you on the art of espresso. We'll need you at least 20 hrs/week. Must have reliable transportation. -...
...available during the following times:o 3am-10am EST (Monday to Friday) WHAT DO I NEED TO GET STARTED? Because youll be teaching online from your home, youll need your own computer and a good internet connection. All of our classes are conducted 1-on-1 via our...
...Embark on a virtual business opportunity that caters to travel lovers who are enthusiastic about helping others explore the world. No prior experience is necessary we provide extensive training, certification, and a personalized website to launch your journey into...
...the state of Connecticut Position Purpose Our home health aides provide paraprofessional services to our patients in their... ...services as assigned. Assists clients in self-administration of medication. This procedure must be assigned by an RN and documented in the...
...We have an immediate need for experienced Field Inspectors for a heavy civil project in New Jersey. Come join our team! We are looking to build services and capabilities through the growth of our key asset - our staff. Ranked among the nation's top A/E firms...