You could be the one who changes everything for our 26 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.

Develops goals, work plans and schedules for regional provider relations staff and ensures that they are executed. Responsible for the day-to-day supervision and monitoring of provider relations administration and operations for regional and/or statewide providers.
Responsible for timely data analysis and held accountable that information is presented internally and externally in an accurate, timely and professional manner, including presentations and education as needed.
Oversees monitoring of SHP provider network database for accuracy and timeliness; makes corrections as needed.
Plans and coordinates the addition of health care providers within an assigned geographical area and monitors the performance and capacity of existing providers; researches and recommends the addition of health care providers within an assigned geographical area.
Plans and coordinates as necessary, support and activities with important community organizations to facilitate positive working relationships.
Determines which providers need assistance in managing Health Net programs, and assists them in developing corrective action plans.
Develops approach to improve and enhance the image of the company with providers/practitioners/program representatives.
Facilitates problem resolution for complex problems between providers, marketing, claims, member relations and employer groups.
Develops and executes a “Net Growth” plan to maximize membership growth statewide and within targeted market segments.
Collaborates with internal departments to facilitate improved encounter data submissions, increased HEDIS scores, STAR rating, NCQA scores, and other regulatory measures.
Where appropriate, interfaces with state and local officials, committees, and collaborates to continually improve Health Net and SHP positioning to achieve organizational goals
Ensures that Provider Relations staff is adequately trained in all skills necessary and appropriate to their job, including but not limited to the following areas: contract interpretation and clarification, marketing programs, Health Net products, customer service, provider relations interactions, regulatory requirements, and project management.
Consults with Organization Effectiveness on Human Resources related issues for the region, including but not limited to selection, conflict resolution, staff development, and performance evaluations.
Other duties as assigned.

Pay range: $99,000 to $183,200 per year

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. The employee may be eligible for bonuses and other forms of compensation.

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.