Centene Corporation Supervisor, Provider Network in Tempe, Arizona
Position Purpose: Supervise and coordinate the operations of the network accounts department
- Supervise the day-to-day workflow of the network accounts function in compliance with health plan, corporate and state policies, procedures and guidelines
- Assist with provider contracting activities to minimize contract implementation issues/errors
- Receive and respond to all escalated provider issues and ensure standards are established, met and maintained
- Plan, coordinate and participate in scheduled and unscheduled meetings with network account representatives to conduct orientations, train on health plan policies and procedures, deliver materials or inquire about contracting with our health plan
- Review and audit network accounts documentation for compliance with health plan and State standards
- Analyze, develop, implement and monitor quality initiatives to achieve healthy outcomes for assigned projects
- Assist in the resolution of claims payment and provider systems set-up issues
- Coordinate and host health plan-sponsored events held for network account representatives
- Assist in the development of policies and procedures and update and maintain the Provider Manuals
Education/Experience: Bachelor s degree or equivalent experience. 3 years of network account management, provider contracting or billing experience in a managed care environment. Supervisory or lead experience preferred. Knowledge of managed care and state Medicaid program guidelines. Proficiency in Microsoft Office products.
Licenses/Certifications: Current state driver s license.
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.
Job: Network Development & Contracting
Organization: Bridgeway Health Solutions
Requisition ID: 1040288