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.
***NOTE: We are seeking candidates who live near Kansas City, KS for this role***
Position Purpose: Acts as a liaison between Tier I providers (hospital systems, large multi-specialty groups, providers on value-based contracts and/or those with complex contracts) and the health plan. Manages Network performance for assigned territory through a consultative/account management approach. Drives provider performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc. Evaluates provider performance and develops strategic plan to improve performance. Performs detailed HBR analysis. Facilitates provider trainings, orientations, and coaches for performance improvement within the network and assists with claim resolution.
Education/Experience: Bachelor’s degree in related field or equivalent experience. Five + years of combined provider relations, provider claims/reimbursement, or contracting experience. Knowledge of health care, managed care, Medicare or Medicaid. Bachelor’s degree in healthcare or a related field preferred. Claims billing/coding knowledge preferred.
For Sunflower Health Plan: Must have prior customer service experience and insurance Claim experience with training in billing. Pay Range: $67,400.00 - $121,300.00 per yearCentene 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
...Responsibilities: Electrician I: Under direct supervision, applies knowledge, skills... ...Electrician qualifications, training, experience and technical knowledge. Responsible for... ...license with at least four years as an apprentice plus two years of experience as a journeyman...
...Operations Description SUMMARY: The Enterprise Application Systems Manager is responsible for the effective management and... ...monitoring, and coordination of support for the following systems: Epic Server Management Management of Epic Sandbox Environments...
...accepted: Yes ~ RTO Restrictions: 7 days within 13 week contract Schedule Information Guaranteed Hours: 36 Hours RTO at Christmas cannot be accommodated Unit Specific Information ~ Medical Surgical - To mirror the diagnosis seen on 3100 and some patients...
...Projects Ability to implement new processes Knowledge of Internal Control Review For more information on this Assistant Controller/Sr Accountant role and other full time accounting and finance opportunities, please contact us at 302.985.5215 and reference JO#....
...Job Description Job Description Position summary: Provide clerical and health related assistance to physicians and assist with general office & patient needs during business hours. Maintains timely follow up of any physician orders/instructions and patient inquiries...