Provider Data Management Spec I

Centene Corporation

18h • Hybrid

About The Position

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. This role is responsible for maintaining accurate databases and reports to monitor network compliance with State requirements. The position involves creating and maintaining multiple databases, overseeing the provider termination process, scheduling provider verifications, updating delegated provider documents, and providing reports and statistical data to other departments. General administrative tasks are also part of the role.

Requirements

• High school diploma or equivalent.
• 2+ years of provider data or network administration experience, preferably in a managed care setting.

Nice To Haves

• Associate’s degree in health care or a related field preferred.

Responsibilities

• Maintain accurate databases and reports to monitor network compliance with State requirements
• Create and maintain multiple databases, including, contract provider network, prior authorization, third party liability, provider set ups and related corrections
• Oversee the provider termination process including adding and changing new or existing provider records in the medical information system
• Schedule monthly provider verifications regarding provider enrollment specifications and demographic changes
• Update delegated provider Medicare and Medicaid documents on a monthly and ad hoc basis and ensure state compliance
• Provide appropriate reports and statistical data to other department designees for review, follow-up and resolution
• Perform general administrative tasks in support of assigned department
• Performs other duties as assigned.
• Complies with all policies and standards.

Benefits

• competitive pay
• health insurance
• 401K
• stock purchase plans
• tuition reimbursement
• paid time off
• holidays
• a flexible approach to work with remote, hybrid, field or office work schedules.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees