Jobs for Humanity is partnering with Centene to build an inclusive and just employment ecosystem. Therefore, we prioritize individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard of Hearing, Black, Hispanic, Asian, Military Veterans, the Elderly, the LGBTQ, and Justice Impacted individuals. This position is open to candidates who reside in and have the legal right to work in the country where the job is located.

Company Name: Centene

Join Our Team and Make a Difference!

At Centene, we believe in transforming the health of our communities, one person at a time. We are a diverse national organization with 28 million members, and we invite people from all walks of life to be a part of our mission. We value inclusivity and offer competitive benefits, as well as workplace flexibility.

Oklahoma Complete Health, a Centene company, is dedicated to improving the health of Oklahomans. We are seeking individuals who are passionate about community advocacy and want to contribute to an inclusive culture that promotes work-life balance, offers competitive compensation, and provides continuous career development. Join our collaborative network of innovative thinkers and help deliver solutions at the local level.

***Must Reside in Oklahoma*** Position: Provider Relations Representative

As a Provider Relations Representative, you will act as a liaison between Tier II providers and our health plan. Your main responsibility will be managing network performance for your assigned territory and driving provider performance improvement in various areas. Additionally, you will provide support to providers, assist with claim resolution, and educate them on our policies and procedures.

Your Responsibilities:

• Be the primary point of contact for providers and facilitate communication between providers and the health plan
• Triage and resolve provider issues, working closely with internal partners
• Investigate and communicate provider claim issues and changes
• Educate providers on referrals and claims submission, website usage, and related topics
• Conduct provider orientations and ongoing education
• Manage network performance and develop strategic plans for performance improvement
• Present detailed analysis and reports on network performance
• Develop proficiency in tools and educate providers on their use
• Coach and support new and less experienced team members
• Complete assigned special projects
• Ability to travel locally 4 days a week

Education/Experience Requirements:

To be considered for this role, you should have a Bachelor's degree in a related field or equivalent experience. Ideally, you will have at least three years of experience in provider relations, provider claims/reimbursement, or contracting. Knowledge of health care, managed care, Medicare or Medicaid is preferred. Claims billing/coding knowledge is also desirable.

Why Join Our Team:

We offer a comprehensive benefits package that includes:

• Flexible work solutions, including remote options and hybrid work schedules
• Competitive pay
• Paid time off, including holidays
• Health insurance coverage for you and your dependents
• 401(k) and stock purchase plans
• Tuition reimbursement
• Best-in-class training and development opportunities

Centene is an equal opportunity employer that values diversity and believes in creating an inclusive workplace. We celebrate the uniqueness of each individual. 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 any other characteristic protected by applicable law.