Provider Relations Specialist II

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: Serve as a liaison between providers, the health plan and Corporate to investigate and resolve provider claims

• Conduct on-site provider orientations, including writing and updating orientation materials and assisting providers acclimated to plan website
• Monitor financial performance of contracts
• Investigate and document provider changes and correspondence
• Coordinate with credentialing to ensure all appropriate documentation is received
• Serve as a lead for key special projects
• Recommend changes in pricing subsystems
• Coordinate printing of provider directories with corporate and plan level entities
• Investigate and respond to complex provider related issues and initiate change of provider related database information
• Serve as a subject matter expert for provider relations activities and as a mentor for Provider Relations Specialist I staff
• Ability to travel
• Performs other duties as assigned
• Complies with all policies and standards
• 80% Field Based Travel for provider visits in the AR county assignments - Crawford, Franklin, Johnson, Logan, Montgomery, Perry, Polk, Pope, Scott, Sebastian, and Yell
• 20% in office trainings and meetings

Highly Preferred Experience

• Community Relations
• Project Management
• Project Coordinator
• Public speaking and presenting
• ​Strong organizational skills

Education/Experience: High school diploma or equivalent. Bachelor’s degree in healthcare related field preferred. 5+ years of sales, provider relations, or contracting experience. Claims processing and/or managed care experience preferred. Driver’s License may be required by some plans. Specific language skills may be required by some plans.
License/Certification: Valid driver's license.
For Fidelis Care only: Must have valid driver license, personal vehicle and ability to travel.

Pay Range: $54,000.00 - $97,100.00 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.  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