Provider Network Manager

Centene Corporation

1d•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. 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

Requirements

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