Company

Centene Corporation

Description

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.

Position Purpose Implement development activities for the recruitment, contracting and retention of providers. Negotiate contracts and develop strategies and methodologies for specific network development initiatives.

Monitor business processes related to provider contracting to determine their efficiency and protective value, and assure integrity of records, information and systems in compliance with Company policies/standards and government regulations.
Prepare provider contracts and monitor process to ensure timely execution of contracts.
Manage fee schedules, ensuring timely and accurate loading in company IS system.
Monitor and oversee provider contract compliance and issue corrective action letters for non -compliance.
Conduct and oversee administrative audits of provider agencies.
Prepare and analyze reports and records on functional area and on organizational activities, recommend improvements for upper management.
Monitor operational and financial performance of agreements using results to guide future negotiations.
Meet individually with providers to develop long-term relationships and resolve operational issues.
Review redline contract language and provide accept/decline recommendations to management.

Education/Experience Bachelor’s degree in related field or equivalent experience. Master’s degree preferred. 5+ years of contracting, network development and/or provider relations experience. Project management experience. Experience in a healthcare or insurance environment, preferably in Medicaid. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

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.

Identifier

6daf66f18184e8fb2535043a87f08e52