You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
- Manage vendor utilization including work flows for coordinating services with the Health Plan
- Analyze vendor data and complete required reports for the health plan, Corporate and state
- Create and manage vendor scorecard and associated ratings/correction plans
- Perform as a key account manager for the Health Plan to coordinate with high priority providers and vendors
- Coordinate with Corporate Vendor Management team regarding vendor expectations, performance and procedures
- Coordinate with Medical Management, Member Services and Provider Services to educate and communicate expectations, performance and procedures to vendors
- Conduct monthly meetings and document discussions, issues, attendees, action items, research and resolve claim disputes with vendor, member or provider issues and route to appropriate person(s) for resolution
- Receive and respond to provider related database information requests and concerns
- Ensure operation integrity, including compliance with all policies and procedures for the Health Plan including adherence to state contract and guidelines
- Request and/or assist in the development of correction action plans for standards that are not met by the vendor
- Bachelors’ degree in public health, business or related field or equivalent experience.
- 4+ years of healthcare management experience, preferably in vendor managed care or the health insurance field.
- Experience developing, rolling out and maintaining vendor management best practices preferred
- Experience with reporting and analyzing data preferred.
- Strong Excel skills and working with a variety of software data programs preferred.
- Vendor Management and Project management experience a plus.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
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.