You could be the one who changes everything for our 26 million members.
Centene is transforming the health of our communities, one person at a time.
As a diversified, national organization, youll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: The Provider Engagement Administrator I is the internal and external liaison for the Provider Network Department who maintains positive working relationships with participating physicians, participating physician groups (PPGs), and ancillary providers within an assigned area.
Responsible for daily administration and operation of the contractual provider relationships including overseeing accurate and current provider databases, providing training, education and information to providers, and researching, analyzing and resolving complex problems dealing with contract loading, division of financial responsibility interpretation, contract rate and language interpretation, appeals, grievances and eligibility.
Act as the internal and external liaison for the Provider Network Management Department who maintains positive working relationships with participating physicians, participating physician groups (PPGs), multi-specialty groups, and/or ancillary providers within an assigned area.
Acts as account manager for assigned groups acting as gatekeeper for interactions with other internal departments.
Responsible for daily administration and operation of the contractual provider relationships including overseeing accurate and current provider databases, providing training, education and information to providers Researching, analyzing and resolving complex problems dealing with contract loading, division of financial responsibility interpretation, contract rate and language interpretation, appeals, grievances and eligibility.
Special projects as assigned.
Education/Experience: Bachelors degree in healthcare field or equivalent.
0 to 1 more years of progressive provider services experience.
Experience in a managed health care environment with exposure to provider contracting, servicing benefits interpretation, and internal operations of provider relations function.
Intermediate demonstrated analytical skills; Intermediate demonstrated problem solving skills; Intermediate to advanced Microsoft Excel.
License/Certification: Drivers license required.
60-80% local travel, with rare need for overnight travel.
Ideal candidates will reside in Osceola, Brevard, or Orange Counties in the state of Florida.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
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.
TITLE: Provider Engagement Administrator I LOCATION: Various, Florida REQNUMBER: 1395416