Provider Engagement SpecialistTacoma, Washington Apply Now Job ID 1173031 Category Government Relations Organization Federal Services Schedule Full-time
Conduct provider orientations as well as ongoing provider education to enhance provider relationships and ensure optimal customer satisfaction or CPARs results
Educate providers on HNFS and TRICARE policies and procedures related to referrals, claims submission, credentialing documentation, web site education, and clear and legible report requirements
Resolve provider issues by researching and analyzing provider contracts and system data to identify root cause
Perform contracting duties as requested, including but not limited to submitting changes to provider related database information, sending contracts, and assisting in the completion of special projects
Support network growth and development including the preparation of contract materials for provider recruitment projects
Perform provider data audits and work with other groups to identify and correct provider data issues
Perform health plan provider orientations and conduct ongoing educational outreach with a focus on improving quality and satisfaction within the provider network. Act as liaison between providers and the health plan to resolve all issues and enhance the business relationship. Ensure provider compliance with TRICARE policy.
Bachelor's degree in Business Administration or a related field or equivalent experience. 2+ years of managed care or healthcare experience.
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.
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