Overview
USD 55,100.00 - 99,000.00 per year
Full Time
Skills
Management
Facilitation
GeoAccess
Network Analysis
Network
Project Development
Corrective And Preventive Action
Service Delivery
Data Integrity
Health Care
Insurance
Project Management
Statistics
Health Insurance
Forms
Law
Job Details
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.
Position Purpose: Monitor and oversee network development efforts including facilitating network transitions and developing and maintaining the network analysis and network development plans. Monitor network performance.
Education/Experience: Bachelor's degree or equivalent experience. 3+ years of experience, preferably in the healthcare or insurance industry. Provider relations experience preferred. Project Management and statistical analysis experience preferred.
We are looking for someone in the state of Michigan to fill the role.
The position is remote, but it will require occasional travel to the Detroit office, potentially as often as once/month.
Pay Range: $55,100.00 - $99,000.00 per year
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
Position Purpose: Monitor and oversee network development efforts including facilitating network transitions and developing and maintaining the network analysis and network development plans. Monitor network performance.
- Develop and maintain all required State and health plan network reports including GeoAccess analysis, network readiness reports, etc.
- Develop and maintain provider transition spreadsheets.
- Review provider data reports and monitor network adequacy to provide recommendations for network enhancements
- Assist with the completion of annual and quarterly network analyses.
- Track and monitor all activities of the network development plans.
- Prepare network data for internal and external customers.
- Implement project plans and assist with project development efforts.
- Coordinate the completion of Arizona System of Care Plans.
- Work with providers to verify accuracy and timeliness of data submissions.
- Review provider profiles, implement and review corrective action plans as needed, and submit provider service delivery reports.
- Monitor and maintain internal and provider data integrity and facilitate data clean up.
- Create provider, claims, and membership data reports and data reconciliation
- Provide formal provider staff trainings as needed.
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience: Bachelor's degree or equivalent experience. 3+ years of experience, preferably in the healthcare or insurance industry. Provider relations experience preferred. Project Management and statistical analysis experience preferred.
We are looking for someone in the state of Michigan to fill the role.
The position is remote, but it will require occasional travel to the Detroit office, potentially as often as once/month.
Pay Range: $55,100.00 - $99,000.00 per year
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
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.