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
...A respected law firm in San Diego is seeking a seasoned Legal Assistant with a strong background in Healthcare law to join its collaborative... ...with experience. ~ Hybrid work schedule eligible for one remote day per week after initial training period. ~ Comprehensive...
...Job Description Primary Care (Russian Speaking) Opening in Brooklyn, NY (Permanent) Located in South Brooklyn - 30 minutes from ManhattanFull time, permanentMultispecialty group is seeking a primary care provider. The patient population is largely Russian-speaking...
...Description Job Description Mobile Maintenance, a leading oil and gas services company is hiring Field Service Technicians! Our established maintenance... ...per customer demands. No previous Oil & Gas experience is required for the right candidate. Must be willing...
...trailers. Clark Transfer operates directly in 48 states and Canada. Clark Transfer continues today under the same ownership and management. It is widely recognized as the gold standard for transportation in the theatrical industry. Benefits: ~ Most singles earn...
...perfect time to build a career in a high-demand trade. No foundry experience is requiredwell provide all the training you need. Why... ...parts and products for industries like mining, marine, HVAC, and oil & gas Roles may include sand molding, melting & pouring,...