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 are currently seeking an experienced (Preferably Court Certified) Spanish interpreter for a medical malpractice deposition. Details are as followsDate: December 4th Arrival time: 8:45 am Start time: 9:00 am Location: 222 Delaware Avenue, Wilmington, DE...
...formerly Waste Management) team today I. Job Summary The Driver Container safely operates a heavy-duty crane mounted truck and... ...(s) of relevant work experience operating a vehicle requiring a CDL or equivalent military driving within the last 7 years. B. Certificates...
...The selector pulls case orders on an electric pallet jack, organizes the product by assignment, and loads on a designated route in a fast-paced team environment. RESPONSIBILITIES - Selects orders assigned by operations clerk, and loads onto the prope Order Selector, Warehouse...
...Role: Web Developer Location: Cincinnati, OH Type: Full Time or Contract Reports To: Chief Architect / Product Owner About the Role We are seeking a skilled and motivated Web Developer to design, build, and maintain modern, responsive web applications...
...We are looking for an in-house React Native Developer with a strong foundation in TypeScript and Expo to join our team. While extensive experience is not required, you should have a solid understanding of modern frontend technologies and a willingness to learn. You will...