Senior Provider Engagement Network Specialist

Job not on LinkedIn

🔥 0 minutes ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $56.2k - $101k / year

⏰ Full Time

🟠 Senior

🛜 Network Engineer / Network Administrator

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Assure providers are set up accurately in the provider information system for state reporting, claims payment, and directories • Manage state deliverables, network reporting, directories, and claims payment resolution related to provider setup • Support external provider representatives in resolving provider data issues • Research and respond to provider-related issues • Act as internal and external liaison for provider networking • Maintain relationships with participating physicians, physician groups, multi-specialty groups, and ancillary providers • Act as account manager and gatekeeper for assigned groups • Administer contractual provider relationships and maintain accurate provider databases • Provide training, education, and information to providers • Research, analyze, and resolve complex contract, claims, eligibility, appeals, grievance, and provider data issues • Serve as primary liaison between assigned providers and the health plan • Act as department subject matter expert • Perform other duties as assigned and comply with policies and standards

🎯 Requirements

• Must reside in New Jersey • Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Bachelor’s degree in healthcare related field or equivalent experience required • 5+ years of provider services experience required • Experience in a managed health care environment • Exposure to provider contracting, servicing benefits interpretation, and internal operations of provider relations • Experience with provider information systems, provider data, contract loading, contract rates and language, appeals, grievances, eligibility, claims, and data issue resolution

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • Stock purchase plan • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation