Provider Partnership Associate
| Company | Centene |
|---|---|
| Location | Long Island City, Queens, NY, USA, New York, NY, USA, Flushing, NY, USA |
| Salary | $55100 – $99000 |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Mid Level |
Requirements
- Bachelor’s Degree in related field or equivalent experience
- 3+ years of combined managed healthcare and provider reimbursement experience
- Current state driver’s license
Responsibilities
- Conduct initial provider orientations as well as ongoing educational outreach
- Educate providers regarding policies and procedures related to referrals, claims submission, web site education, Electronic Health Records, Health Information Exchange, and Electronic Data Interface
- Engage providers on Patient Centered Medical Home initiatives
- Perform detailed HBR (Health Benefits Ratio) analysis and create reports for provider
- Review provider performance by both quantitative metrics and qualitative factors
- Create and communicate milestone documents, dashboards and success metrics
- Act as a liaison between the provider and the health plan ensuring a coordinated effort in improving financial and quality performance
- Provide status updates for providers regarding incentive agreements
- Conduct site visits when required and other Contracting duties as requested
- Ability to travel
- Performs other duties as assigned
- Complies with all policies and standards
Preferred Qualifications
- Clinical or health information management (HIM) experience preferred