Provider Data Management Specialist I

Centene

70d • $19 - $32 • Remote

About The Position

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.

Requirements

• High school diploma or equivalent
• 2+ years of provider data or network administration experience, preferably in a managed care setting
• Proficient in Microsoft Office applications, preferably Access and Excel
• Previous experience with database management, reporting and analysis preferred
• Associate's degree in health care or a related field preferred

Nice To Haves

• For Sunflower plan only: 2+ years of experience, preferably in a managed care setting

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

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field or office work schedules

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED