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Centene Corporation Director, Provider Relations in East Syracuse, New York

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.

Position Purpose: Oversee the Provider Relations department including negotiations and administering organization policies and procedures.

Oversee the Provider Relations department to ensure in compliance with company policies and standards, government laws, regulations and contracting standards.

Develop, implement and monitor policies and procedures.

Develop tactical plans to align strategies and technologies with future needs.

Effectively manage budget and all resources for short and long-term needs.

Prepare and analyze reports on departmental and organizational activities and recommend improvements.

Ensure timely Provider set up processing, auditing and distribution of Provider Relations data management.

Create effective organizational structure and develop staff skills and competencies.

Develops and maintains positive relationships with providers and related representatives.

Collaborate and partner with Marketing to increase membership and market share within the region

Responsible for hiring and retention of quality staff including training, coaching, evaluation and appraisal of staff performance and development

Facilitates positive working relationships with internal departments to ensure timely resolution of issues

Education/Experience: Bachelor’s degree in a Business Administration, Healthcare Administration, related field or equivalent experience. 7+ years of provider relations or contracting experience in a managed care or insurance environment, preferably in Medicare or Medicaid. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

License/Certification: Valid driver's license.

For Fidelis Care only: Must have valid driver license, personal vehicle and ability to travel.

DE Only: Resolves provider billing and payment issues, including providing technical assistance to all participating providers to resolve claims issues. Understands provider billing and payment requirements across all lines of business and is well-versed in payment systems.

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.

TITLE: Director, Provider Relations

LOCATION: East Syracuse, New York

REQNUMBER: 1350903