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Centene Corporation
Centene Corporation
SvetovanjeZavarovanjeZdravstveno varstvo
Centene Corporation je zdravstvena in zavarovalniška družba, osredotočena na zdravstveno kritje, ki ga podpira država, ter zdravje skupnosti. Njene storitve vključujejo Medicaid, Medicare, načrte zdravstvenega zavarovanja na trgu zdravstvenega zavarovanja in podporo programu TRICARE za vojaške skupnosti. Centene združuje lokalizirano zagotavljanje zdravstvene oskrbe s partnerstvi z neprofitnimi organizacijami, da bi zadovoljila potrebe članov, ki jim služi. Družba v svoj pristop k poslovanju in podpori skupnostim vključuje tudi odgovornost do okolja in etično upravljanje.
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Delovna mesta v podjetju

Provider Engagement Account Manager – Florida

Build and support Centene’s contracted provider network in Florida. Help providers improve quality, cost, utilization, claims resolution, and network performance.

USZdružene države AmerikeFLFlorida
56.200 $ – 101.000 $ / leto
HibridnoPolni delovni časJuniorSrednja ravenZahtevani Jezik: angleščinaProdajaSkrbnik strank

Opis

  • Maintain relationships between the health plan and contracted provider networks
  • Build client relationships that support high-quality care for members
  • Work with providers to identify network performance opportunities and solutions
  • Manage accounts consultatively and take responsibility for resolving issues
  • Improve contract incentive results, quality, cost, and utilization
  • Act as providers’ main contact and connect them with the health plan
  • Route provider issues to the appropriate internal teams
  • Address issues raised by external providers
  • Investigate and resolve provider claim issues, and communicate related changes
  • Update provider demographic information
  • Guide providers on referrals, claims submission, website use, EDI solicitation, and related topics
  • Lead provider orientations and ongoing education, and create or update orientation materials
  • Oversee network performance in an assigned territory through consultative account management
  • Assess provider performance and create targeted improvement plans
  • Support provider improvement in Risk/P4Q, HBR, HEDIS and quality, cost, and utilization
  • Complete special projects and other assigned work
  • Follow applicable policies and standards

Zahteve

  • Applicants must live in one of these Florida counties: Indian River, Martin, Okeechobee, Palm Beach, or St. Lucie
  • Bachelor’s degree in a related field or equivalent experience
  • Two years of experience in managed care, a medical group, provider relations, quality improvement, claims, contracting, utilization management, or clinical operations
  • Project management experience in a medical group, IPA, or health plan setting
  • Proficiency in HEDIS and quality measures, cost, and utilization
  • Ability to travel locally four days per week

Ugodnosti

  • Competitive pay
  • Health insurance
  • 401(k)
  • Stock purchase plans
  • Tuition reimbursement
  • Paid time off and holidays
  • Flexible remote, hybrid, field, or office work schedules
  • Additional incentives may be included in total compensation

Sorodna delovna mesta

PMA Consultants

NetSuite Project Accounting Specialist

PMA Consultants
201 – 500 Zaposleni
Sponzor vizuma H1BLogistikaProizvodnjaZdravstveno varstvo
USZdružene države AmerikeMIMichigan
83.082 $ – 97.621 $ / leto
HibridnoPolni delovni časSrednja ravenSeniorZahtevani Jezik: angleščinaVodja računovodstva
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Manage NetSuite billing and project financial records for PMA Consultants’ construction consulting work, coordinating with project managers, finance, operations, and clients. Track budgets, invoices, expenses, and payment issues across the project lifecycle.

Odpri