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Supervisor, Provider Network

Role overview

Qualifications

  • 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

Responsibilities

  • Supervise the day-to-day workflow of the network accounts function in compliance with health plan, corporate and state policies
  • 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
  • Analyze, develop, implement and monitor quality initiatives to achieve healthy outcomes for assigned projects

Key facts

Hard skills

Other skills

  • Supervision
  • Communication
  • Problem Solving

About the company

Centene Corporation logo

Centene Corporation

Health Insurance (Payers)

Centene Corporation provides high-quality healthcare services to members in all 50 states. Since its founding in 1984, Centene has worked to transform the health of communities, one person at a time. Centene is the largest Medicaid managed care organization in the country and provides a portfolio of services to government sponsored healthcare programs. Centene believes that healthcare is best delivered locally. Our local health plans offer a range of health insurance solutions with a focus on providing accessible care to uninsured and under-insured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). Centene also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services. Centene’s hiring practices reflect the composition of the members and communities we serve, allowing us to deliver quality, culturally sensitive healthcare to millions of members. Centene employees help change the world of healthcare and transform our communities. To learn more about career opportunities with Centene, visit: https://jobs.centene.com/

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

Position Purpose: Supervise and coordinate the operations of the network accounts department

Key Details: This position is open nationwide.

  • 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.

Pay Range: $56,200.00 - $101,000.00 per year

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
 

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

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
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