Centene Corporation Provider Partnership Associate (Sacramento OR Chico) in Sacramento, California

Description:

Position Purpose: Perform initial health plan orientation and conduct ongoing educational outreach with a focus on improving quality and financial outcomes within provider network

  • Conduct initial provider orientations as well as ongoing educational outreach
  • Educate providers regarding policies and procedures related to referrals, claims submission, web site education, Electronic Health Records, Health Information Exchange, and Electronic Data Interface
  • Engage providers on Patient Centered Medical Home initiatives
  • Perform detailed HBR (Health Benefits Ratio) analysis and create reports for provider Review provider performance by both quantitative metrics and qualitative factors
  • Create and communicate milestone documents, dashboards and success metrics
  • Act as a liaison between the provider and the health plan ensuring a coordinated effort in improving financial and quality performance
  • Provide status updates for providers regarding incentive agreements
  • Conduct site visits when required and other Contracting duties as requested
  • Ability to travel

Qualifications:

Education/Experience: Bachelor s Degree in related field or equivalent experience. 3 years of combined managed healthcare and provider reimbursement experience. Advanced knowledge of Microsoft Excel. Clinical or health information management (HIM) experience preferred. Current state 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.

Job: Health Insurance Operations

Organization: Health Net of California

Location: California-Sacramento

Requisition ID: 1068264

Other Locations: USA-California-Chico