Provider Network Manager

Posted 2 Days Ago
Be an Early Applicant
2 Locations
Remote
88K-158K Annually
Senior level
Healthtech
The Role
The Provider Network Manager oversees provider networks, conducts contract negotiations, monitors network adequacy, and resolves claims issues. This role involves financial analysis and compliance with company policies.
Summary Generated by Built In

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.
 

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT

This is a fully remote position open to candidates residing anywhere within the United States.

Position Purpose: The Provider Network Manager manages provider networks for adequacy and access. Conducts high level negotiations and renegotiations of provider contracts. Monitors network adequacy and resolves hospital provider claim issues. Provides regional input and maintenance of provider directory listings. Participates in monthly internal/external meetings involving network activity. Monitors areas credentialing process. Develops provider contracting strategy.

  • Oversees network development and retention strategizing.
  • Oversees network problem resolution (Claims, UM, Etc.).
  • Oversees network analysis for adequacy and recruitment targets.
  • Oversees provider contract negotiations – hospitals, ancillaries, and groups.
  • Provides financial analysis for network development targets.
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Bachelor’s Degree required; Master’s degree preferred (MBA, MHA). Five to seven years in administration and/or negotiation of managed care contracts

Pay Range: $87,700.00 - $157,800.00 per year

Centene 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, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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

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The Company
Columbus, GA
19,002 Employees
Year Founded: 1984

What We Do

Centene provides healthcare solutions to individuals across the United States with more than 23 million members nationwide.

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