Company

Centene Corporation

Description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

On site- 1618 Specker Ave, Bldg 1011 – Ft. Carson, Colorado Springs

Serve as a primary on-site referral/authorization (R/A) point of contact to Military Treatment Facilities (MTF) and Markets. Research and respond appropriately and timely to inquiries from MTF customers. Closely monitor delivery of customer service and support and resolving local R/A problems, issues and concerns. Recommend and implement strategies for resolving issues and improving service quality and timeliness. Process certain referral requests to completion. Educates MTF staff and network providers on submission of Referrals and Authorizations. Maintains database of local network providers on their access to care, preferred providers, and discount rates to leverage when processing.

Process referrals from designated MTFs, ensuring they are assigned to provider able to see beneficiary

Research and respond appropriately and timely to inquiries from MTF/Market

Identify and communicate any trends in referral issues to OIM Management Coordinate with local TRICARE Liaison to address systemic and/or local issues through early identification

Coordinate with local TRICARE Liaison to address systemic and/or local issues through early identification

Maintain knowledge of local network access to care, preferred providers, and discount rates to leverage when processing referrals

Education/Experience Associate’s degree or equivalent experience required. Bachelor’s preferred. Minimum of 2 years of experience working in association with, or for, a DoD Managed Care Support Contractor (TRICARE), Medicare/Medicaid Program, Commercial Healthcare Plan or Healthcare Provider/Group. Functional understanding of how any/all of the above healthcare programs work and their coordinator of benefits. Experience in customer relations, referral processing, and/or the TRICARE program preferred. Government Security/Clearance/Citizenship Requirements. Licensure/Certifications Requires security clearance, CAC/NAC

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.

Pay Range $21.93 - $37.30 per hour

Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

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

2aa8b06e872896de543ea6cd7dd729b4