Centene Corporation

Transforming the health of the communities we serve, one person at a time.

Provider Data Management Specialist I

Data ScientistData ScientistFull TimeRemoteTeam 10,001+Since 1984H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

9 days ago

Salary

Not specified

No structured requirement data.

Job Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

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:

  • Maintain accurate databases and reports to monitor network compliance with State requirements
  • Create and maintain multiple databases, including contract provider network, prior authorization, third party liability, provider set ups and related corrections
  • Oversee the provider termination process including adding and changing new or existing provider records in the medical information system
  • Schedule monthly provider verifications regarding provider enrollment specifications and demographic changes
  • Update delegated provider Medicare and Medicaid documents on a monthly and ad hoc basis and ensure state compliance
  • Provide appropriate reports and statistical data to other department designees for review, follow-up and resolution
  • Perform general administrative tasks in support of assigned department
  • Performs other duties as assigned
  • Complies with all policies and standards

Qualifications

  • High school diploma or equivalent
  • 2+ years of provider data or network administration experience, preferably in a managed care setting
  • Associate’s degree in health care or a related field preferred

Requirements

  • ***NOTE: For this role we are seeking candidates who live in the Eastern or Central Standard Time zone***

Benefits

  • Competitive pay
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • Flexible approach to work with remote, hybrid, field or office work schedules

Company Description

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.

Job Requirements

  • High school diploma or equivalent
  • 2+ years of provider data or network administration experience, preferably in a managed care setting
  • Associate’s degree in health care or a related field preferred
  • NOTE: For this role we are seeking candidates who live in the Eastern or Central Standard Time zone***

Benefits

  • Competitive pay
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • Flexible approach to work with remote, hybrid, field or office work schedules

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