Supervisor, Provider Relations

Centene Corporation • New York, NY

7d • 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. This position is a remote role but requires the individual to be located in the greater NYC area to be able to attend quarterly meetings in the Long Island City office. Position Purpose: Supervise and coordinate the operations of the provider relations department Assist in the resolution of claims payment and provider set-up issues Supervise the day-to-day workflow of the provider relations function in compliance with health plan, corporate and state policies, procedures and guidelines Train and update staff regarding policies and procedures Receive and respond to emergent provider issues Ensure standards are met and maintained Plan, coordinate and participate in scheduled and unscheduled meetings with providers to conduct orientations, train providers on health plan policies and procedures, deliver materials or inquire about contracting with our health plan Review provider change forms for accuracy Coordinate and attend health plan sponsored provider functions Assist in the development of policies and procedures Update and maintain Provider Manual Performs other duties as assigned Complies with all policies and standards

Requirements

• Bachelor’s degree in Marketing, Communications, Public Relations or Business or equivalent experience.
• 4+ years of provider relations, marketing, customer service and/or claims processing/billing experience in a managed care environment.
• Knowledge of managed care and state Medicaid program guidelines.
• Must have valid driver license, personal vehicle and ability to travel.

Nice To Haves

• Supervisory or lead experience preferred.

Responsibilities

• Supervise and coordinate the operations of the provider relations department
• Assist in the resolution of claims payment and provider set-up issues
• Supervise the day-to-day workflow of the provider relations function in compliance with health plan, corporate and state policies, procedures and guidelines
• Train and update staff regarding policies and procedures
• Receive and respond to emergent provider issues
• Ensure standards are met and maintained
• Plan, coordinate and participate in scheduled and unscheduled meetings with providers to conduct orientations, train providers on health plan policies and procedures, deliver materials or inquire about contracting with our health plan
• Review provider change forms for accuracy
• Coordinate and attend health plan sponsored provider functions
• Assist in the development of policies and procedures
• Update and maintain Provider Manual
• Performs other duties as assigned
• Complies with all policies and standards

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level