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
...Job Description Job Title: Night Dispatcher Heavy Duty Fleet Operations Type: Perm Start Date: ASAP Location: Clifton NJ - On-site MondayFriday | Remote Saturdays Schedule: 5:00 PM 3:00 AM Compensation: ~$75,000 base (some flexibility based...
...Tolleson Operation: Hiring Qualified Drivers Position Highlights:... ...of verifiable experience. Semi-truck 53ft trailer experience.... ...all three) Mostly PM driving Local/Intrastate AZ: Mostly late afternoon... ...mentioned lanes/runs until a dedicated lane is available....
...Intelligence & Security (I&S) Sector as a Senior Safety, Health, & Environment (SHE) Specialist. This position will be based out of the BAE Systems Lexington Park facility. The SHE Specialist Senior will support our Lexington Park, St. Inigoes and other sites across the east...
At Lawyers for Justice, we are dedicated to advocating for the rights of employees and providing compassionate, expert legal representation in cases involving sexual harassment, discrimination, and California Fair Employment and Housing Act (FEHA) violations. We are seeking...
...in heavy civil construction (Infrastructure, Utilities, Underground water lines, Civil Excavation, Earthwork, Site Preparation, Demolition). Preferably will have some Environmental experience (Remediation work, demolition, waste management, storm water services etc.)...