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
...Info: Sign on Bonus Available! Job Summary Were looking for positive, compassionate, hardworking registered nurses (RN) who can provide the high-quality care patients and families have come to expect from us. In our fast-paced work environment, the...
Speech Pathologist Career Opportunity Welcome to Encompass Health: Where Compassion Meets Speech Therapy Are you searching for a career that aligns with your passion and brings fulfillment close to home? At Encompass Health, we greet you like an old friend...
...be a great next career step! We are currently seeking a Phlebotomist for a position at Mercy Hospital in Oshkosh this role you will... ...certification from an accredited agency is preferred Previous experience as a phlebotomist is preferred Proven track record in...
...(k) with employer matching ~ Paid time off ~50% Discount at all Terratron food and beverage outlets ~ Worldwide Discounts for Hotel stays! ~ Free parking by Minneapolis/St. Paul Airport ~ Free uniforms ~ Mall of America Discount Booklet ~ Now offering DailyPay...
Position Summary: The System Administrator will manage, maintain, and support Nutanix Hyperconverged Virtual environments and Marine Corps FRCS servers at Camp Lejeune. The candidate will ensure compliance with cybersecurity policies, provide RMF support, troubleshoot...