Provider Network Manager
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Florida • Montana • United States
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Salary
💰 $87,700 - $157,800 per year
About the role
- Manage provider networks for adequacy and access
- Conduct high level negotiations and renegotiations of provider contracts
- Monitor network adequacy and resolves hospital provider claim issues
- Provide regional input and maintenance of provider directory listings
- Participate in monthly internal/external meetings involving network activity
- Monitor areas credentialing process
- Develop provider contracting strategy
- Oversee network development and retention strategizing
- Oversee network problem resolution (Claims, UM, Etc.)
- Oversee network analysis for adequacy and recruitment targets
- Oversee provider contract negotiations – hospitals, ancillaries, and groups
- Provide financial analysis for network development targets
- Perform other duties as assigned
- Complies with all policies and standards
Requirements
- Bachelor’s Degree required; Master’s degree preferred (MBA, MHA)
- Five to seven years in administration and/or negotiation of managed care contracts
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
provider network managementcontract negotiationfinancial analysisnetwork adequacy monitoringcredentialing processprovider contracting strategynetwork developmentproblem resolutionclaims management
Soft Skills
negotiationcommunicationstrategic planningproblem-solvingcollaboration
Certifications
Bachelor’s DegreeMaster’s Degree (MBA, MHA)