Lead Provider Relations Specialist(Job Number: 1077436)Description Position Purpose: Coordinate resolution of escalated issues generated from key stakeholders within an assigned service areas, including partnering with operational leadership.Act as primary liaison between providers, health plans and corporate, including investigating and resolving provider issues. Lead contracting and credentialing efforts in assigned territory where expansion may be required, in addition to states located in new markets.Monitor and analyze costs and prepare departmental budget related to trade-shows and events.Plan, coordinate and develop education activities for provider in assigned states and new markets, including webinars, educational materials and in-person training sessions. Assist with the development of training materials and onboarding program for newly hired staff.Provide day-to-day workflow support of the provider relations function in compliance with health plan, corporate and state policies, procedures and guidelines. Lead and assist with HEDIS quality improvement activities with provider representatives and health Plans in assigned markets.Qualifications Coordinate the operations of the provider relations department. Monitor and perform departmental day to day duties to assure that provider information is accurate for state reporting, claims payment and directories. Education/Experience: High school diploma or equivalent. Bachelor's degree in Marketing, Communications or Business or healthcare related field preferred. 5 years of sales, provider relations or contracting experience. Knowledge of state Medicaid program guidelines, marketing, customer service, contracting and credentialing. Claims processing and/or managed care experience preferred. Supervisory or lead experience preferred.License/Certification: Valid driver’s license.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.
Website : http://www.centene.com
Founded as a single health plan in 1984, Centene Corporation (Centene) has established itself as a national leader in the healthcare services field. Today, through a comprehensive portfolio of innovative solutions, we remain deeply committed to delivering results for our stakeholders: state governments, members, providers, uninsured individuals and families, and other healthcare and commercial organizations