HireMO

Business Area: Provider Networking & Contracting

Job Type: Full time

Position Purpose: Recruit physician, hospital and ancillary service providers to sign network participation agreements that are in accordance with Corporate, health plan and State guidelines. Ensure that all necessary documentation and information are included.

Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J -1, OPT, or CPT.

+ Recruit and develop network for a region and set of providers

+ Lead assigned recruitments (i.e., physician, hospital and ancillary) and ensure they result in complete and accurate standard contracts that meet objectives

+ Facilitate and oversee to the provider set-up and contract configuration to ensure accurate claims adjudication

+ Initiate contact and identify potential providers by geographic and specialty needs and update database

+ Coordinate with internal departments and contracted providers to implement and maintain contract compliance

+ Performs other duties as assigned

+ Complies with all policies and standards

Education/Experience: Bachelor's degree in Healthcare Administration, Business Administration, Marketing, Finance, related field, or equivalent experience. 2+ years of contracting, contract analysis, provider relations, or provider experience in a hospital or physician's office or group setting. Familiarity with State and/or Federal health care programs preferred (Medicaid, Medicare).

Preferred Qualifications:

Experience negotiating with large health systems. Experience with service level negotiations. Although coding experience is not required, some level of knowledge of code-level payment methodologies will be helpful. Experience with Out of Network Agreements preferred.

This is a remote role open to someone working anywhere in the United States that requires occasional travel .

Pay Range: $56,200.00 - $101,000.00 per year

At Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It's work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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