Provider Network Specialist II - Tempe, United States - Oklahoma Complete Health

Oklahoma Complete Health Tempe, United States

1 week ago

Description

Provider Network Specialist II page is loaded

Provider Network Specialist II

Apply

locations

Tempe W. Rio Salado Pkwy (Corp

Remote-AZ

time type

Full time

posted on

Posted 2 Days Ago

job requisition id

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.

Position Purpose:

Perform health plan provider orientations and conduct ongoing educational outreach with a focus on improving quality and financial outcomes within the provider network.

Act as liaison between providers and the health plan to enhance the business relationship.
Conduct initial provider orientations as well as ongoing educational outreach
Educate providers regarding policies and procedures related to referrals, claims submission, credentialing documentation, web site education, Electronic Health Records, Health Information Exchange, and Electronic Data Interface

Enhance account relationships by investigating, documenting and resolving provider matters and effectively handling and responding to account changes and correspondence.

Engage providers and educate them on Patient Centered Medical Home initiatives
Perform detailed HBR (Health Benefits Ratio) analyses, Health Information data Information Set (HEDIS) analyses, and create reports for provider Review provider performance by both quantitative metrics and qualitative factors
Create and communicate milestone documents, dashboards and success or improvement metrics
Act as a liaison between the provider and the health plan ensuring a coordinated effort in improving financial and quality performance
Provide information and status updates for providers regarding incentive agreements
Conduct site visits when required
Perform other contracting duties as requested, including but not limited to recommending changes to pricing subsystems, submitting changes to provider related database information and assisting in the completion of special projects
Ability to travel
Performs other duties as assigned
Complies with all policies and standards
Candidate must reside in the state of Arizona

Education/Experience:
Bachelor's degree in related field or equivalent experience. 2+ years of combined managed healthcare and provider reimbursement experience. Claims processing and/or managed care experience preferred.

Licenses/Certifications:
Current state driver's license.

Pay Range:
$54, $97,100.00 per year

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. Total compensation may also include additional forms of incentives.

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.

Welcome

Thanks for your interest in Centene and its subsidiary companies.

We're so glad that you've decided to fill out an application and take the next step to find your purpose.

Also, we're here to help support you on your candidate journey. Should you need an accommodation, please email

.
About Us

Centene is committed to helping people live healthier lives.

We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.

#J-18808-Ljbffr

Network Operations Specialist

2 weeks ago

Carvana Tempe, United States

**About Carvana** · If you like disrupting the norm and are looking to join a company revolutionizing an industry then you will LOVE what Carvana has done for the car buying experience. Buying a car the old fashioned way sucks and we are working hard to make it NOT suck. I mean, ...
Network Operation Center Specialist

5 days ago

Air Comm Tempe, United States

**About Us** · Join our team · - SentraCam, the premier commercial security division of Air Comm, draws upon over four decades of expertise in supplying communication and public safety equipment to a diverse clientele including police and fire departments, security firms, and bus ...
Network Control Specialist I

6 days ago

Iridium Satellite, LLC Tempe, United States

Company Overview: · Iridium is an award-winning and innovative satellite communications company with bragging rights to the only network that offers voice and data connectivity anywhere in the world. For over 20 years, Iridium's unique network and services have supported critical ...
Network Specialist

1 week ago

TEKsystems Tempe, United States

Job Description · Job Descriptioneq Info · Account name · State Farm General Insurance Company · End Client (if different from Account) · State Farm General Insurance Company · Hiring Manager · Daniel Kirk Johnson · Total Positions · 3 · Duration · 12 · Duration Unit · Month(s) · ...
Network Operations Specialist

6 days ago

Carvana Tempe, United States

About Carvana · If you like disrupting the norm and are looking to join a company revolutionizing an industry then you will LOVE what Carvana has done for the car buying experience. Buying a car the old fashioned way sucks and we are working hard to make it NOT suck. I mean, have ...
Provider Network Specialist II

1 week ago

Oklahoma Complete Health Tempe, United States

Provider Network Specialist II page is loaded Provider Network Specialist II Apply locations Tempe W. Rio Salado Pkwy (Corp Remote-AZ time type Full time posted on Posted 2 Days Ago job requisition id You could be the one who changes everything for our 28 million members. Centene ...
Network Operation Center Specialist

2 days ago

SentraCam Tempe, United States

Job Description · Job DescriptionAbout Us · Join our team · SentraCam, the premier commercial security division of Air Comm, draws upon over four decades of expertise in supplying communication and public safety equipment to a diverse clientele including police and fire departmen ...
Provider Network Specialist II

1 week ago

Centene Corporation Tempe, United States

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, youll have access to competitive benefits including a fresh perspective on workplace flexi ...
Provider Network Specialist II

2 weeks ago

Centene Corporation Tempe, United States

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, youll have access to competitive benefits including a fresh perspective on workplace flexi ...
Network Control Specialist I

6 days ago

Iridium Satellite Tempe, United States

Company Overview · Iridium is an award-winning and innovative satellite communications company with bragging rights to the only network that offers voice and data connectivity anywhere in the world. For over 20 years, Iridium's unique network and services have supported critical ...
Network Support Specialist

1 week ago

Ubiquity Management Group Mesa, United States

Job Description · Job DescriptionSalary: · As a Network Support Specialist, you will support the Network Team ensuring all aspects of projects are completed as efficiently as possible. The main duties include reviewing budgets, project funding, procurement, reviewing inventory l ...
Network Specialist

1 week ago

Fusion HCR Phoenix, United States

We are looking for a Network Engineer/Network Tech for a role in Phoenix Arizona. · Here are some of the details: · Looking for someone with their CCNA · Need to have Route & Switch · Make changes to Palo Alto · Cisco experience · Wireless experience · LAN experience · Aru ...
Security IT Network Specialist

2 weeks ago

Convergint Arizona, United States

Convergint is looking for a full-time, enthusiastic, results driven and forward-thinking IT Network Specialist to join our amazing culture. As an IT Network Specialist, you are a part of a dynamic team that allows you to grow as Convergint grows. · For information about how we us ...
IT Network Specialist 1

1 week ago

Convergint Phoenix, United States

Convergint is looking for a full-time, enthusiastic, results driven and forward-thinking IT Network Specialist to join our amazing culture. As an IT Network Specialist, you are a part of a dynamic team that allows you to grow as Convergint grows. · For information about how we u ...
Network Operations Specialist

2 weeks ago

Wyyerd Group Phoenix, United States

Wyyerd is seeking a Network Operations Specialist to assist across all areas of network deployment and customer installation. Additionally, assisting with procurement and tracking of network related inventory. This position plays a critical role on the Network team, whose primary ...
Network Support Specialist

19 hours ago

Generate Ubiquity Management LLC Arizona City, United States

As a Network Support Specialist, you will support the Network Team ensuring all aspects of projects are completed as efficiently as possible. The main duties include reviewing budgets, project funding, procurement, reviewing inventory levels, and providing recommendations to stre ...
Network Support Specialist

2 days ago

Generate Ubiquity Management LLC Arizona City, United States

As a Network Support Specialist, you will support the Network Team ensuring all aspects of projects are completed as efficiently as possible. The main duties include reviewing budgets, project funding, procurement, reviewing inventory levels, and providing recommendations to stre ...
Transportation Specialist Lead

1 day ago

Amazon Services LLC Tempe, United States

High school or equivalent diploma · - Knowledge of Excel at an intermediate level (e.g., pivot tables & charts, multiple criteria lookups, nested logical/IF formulas, data cleansing, array formulas, etc.) · - Experience managing large data sets and utilizing to drive performance ...
Field Marketing Specialist

1 week ago

Circle K Tempe, United States

**Job Summary**: The** Field Marketing Specialist is responsible for supporting the implementation of the business unit's Fuel & Merchandise Marketing strategy to attain key business objectives. The Field Marketing Specialist will work with the Field Marketing Manager, our Market ...
Level Ii Technician

2 weeks ago

TeamLogic IT Tempe, United States

**Benefits**: · - 401(k) · - 401(k) matching · - Company car · - Paid time off · - Training & development · Please note that this is for our Tempe location. · **Benefits/Perks** · - Flexible Scheduling · - Career Advancement Opportunities · - Competitive Compensation · - People F ...