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Provider Relations Specialist II

Company: Cenpatico
Location: Albuquerque
Posted on: August 16, 2019

Job Description:

Provider Relations Specialist II USA-New Mexico-Albuquerque Position Purpose: Serve as a liaison between providers, the health plan and Corporate to investigate and resolve provider claims * Conduct on-site provider orientations, including writing and updating orientation materials and assisting providers acclimated to plan website * Monitor financial performance of contracts * Investigate and document provider changes and correspondence * Coordinate with credentialing to ensure all appropriate documentation is received * Serve as a lead for key special projects * Recommend changes in pricing subsystems * Coordinate printing of provider directories with corporate and plan level entities * Investigate and respond to complex provider related issues and initiate change of provider related database information * Serve as a subject matter expert for provider relations activities and as a mentor for Provider Relations Specialist I staff * Ability to travel Education/Experience: High school diploma or equivalent. Bachelor s degree in healthcare related field preferred. 5+ years of sales, provider relations, or contracting experience. Claims processing and/or managed care experience preferred. Driver s License may be required by some plans. Specific language skills may be required by some plans. License/Certification: Valid 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. Business Development & Sales Full-time

Keywords: Cenpatico, Albuquerque , Provider Relations Specialist II, Other , Albuquerque, New Mexico

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