Manager, Provider Relations

Centene Corporation

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. Candidates must reside in Illinois. This role will support Region 2 & Region 3. Position Purpose: Responsible for maintaining existing and developing new provider relations, and assisting with contracting activities Manage the staff in Provider Relations area including work flow, training and communication standards Manage day-to-day provider relations activities and provider relations department Develop, implement and maintain production and quality standards for the provider facing staff Monitor and analyze costs and prepare departmental budget Coordinate all pre-contract activities with providers such as, site visits, credentialing, orientation to contractual requirements, etc. Maintain contracts and correspondence files in organized and accessible manner for all providers Prepare and analyze information to evaluate the need for additional health plan providers Manage and coordinate customized provider and hospital relationships Participate in physician and ancillary provider contracting and provider relations Ability to travel up to 50%

Requirements

Bachelor’s degree in related field or equivalent experience.
4+ years of managed care, health delivery system and/or project and staff management experience.
Experience with state and federal health programs such as Medicaid and Medicare.
Provider relations/contracting experience including solid communication and negotiation skills.
Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
Ability to travel up to 50%

Responsibilities

Maintaining existing and developing new provider relations
Assisting with contracting activities
Managing staff in Provider Relations area including work flow, training and communication standards
Managing day-to-day provider relations activities and provider relations department
Developing, implementing and maintaining production and quality standards for the provider facing staff
Monitoring and analyzing costs and prepare departmental budget
Coordinating all pre-contract activities with providers such as, site visits, credentialing, orientation to contractual requirements, etc.
Maintaining contracts and correspondence files in organized and accessible manner for all providers
Preparing and analyzing information to evaluate the need for additional health plan providers
Managing and coordinating customized provider and hospital relationships
Participating in physician and ancillary provider contracting and provider relations