Manager, Provider Relations & Contracting Position Available In Hudson, New Jersey

Job Description:

You could be the one who changes everything for our 28 millionmembers. Centene is transforming the health of our communities, oneperson at a time. As a diversified, national organization, you’llhave access to competitive benefits including a fresh perspectiveon workplace flexibility.

Position Purpose:

Implement developmentactivities for the recruitment, contracting and retention ofproviders. Negotiate contracts and develop strategies andmethodologies for specific network development initiatives.

• Monitor business processes related to provider contracting todetermine their efficiency and protective value, and assureintegrity of records, information and systems in compliance withCompany policies/standards and government regulations.
• Prepareprovider contracts and monitor process to ensure timely executionof contracts.
• Manage fee schedules, ensuring timely and accurateloading in company IS system.
• Monitor and oversee providercontract compliance and issue corrective action letters for non-compliance.
• Conduct and oversee administrative audits ofprovider agencies.
• Prepare and analyze reports and records onfunctional area and on organizational activities, recommendimprovements for upper management.
• Monitor operational andfinancial performance of agreements using results to guide futurenegotiations.
• Meet individually with providers to developlong-term relationships and resolve operational issues.
• Reviewredline contract language and provide accept/declinerecommendations to management.
• Travel up to 50% for providermeetings and team meetings

Education/Experience:

Bachelor’s degreein related field or equivalent experience. Master’s degreepreferred. 5 years of contracting, network development and/orprovider relations experience. Project management experience.

Experience in a healthcare or insurance environment, preferably inMedicaid. Previous experience as a lead in a functional area,managing cross functional teams on large scale projects orsupervisory experience including hiring, training, assigning workand managing the performance of staff. This position is remotewithin the State of New Jersey. Candidates must reside in the stateof New Jersey to be considered. Travel up to 50% for providermeetings and team meetings required. Home office located in Iselin,NJ.

Pay Range:

$86,000.00

• $154,700.

00 per year Centene offers acomprehensive benefits package including: competitive pay, healthinsurance, 401K and stock purchase plans, tuition reimbursement,paid time off plus holidays, and a flexible approach to work withremote, hybrid, field or office work schedules. Actual pay will beadjusted based on an individual’s skills, experience, education,and other job-related factors permitted by law. Total compensationmay also include additional forms of incentives. Centene is anequal opportunity employer that is committed to diversity, andvalues the ways in which we are different. All qualified applicantswill receive consideration for employment without regard to race,color, religion, sex, sexual orientation, gender identity, nationalorigin, disability, veteran status, or other characteristicprotected by applicable law. Qualified applicants with arrest orconviction records will be considered in accordance with the LACounty Ordinance and the California Fair Chance Act