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Provider Relations & Contracting Specialist II -Care1st (Yavapai County)

Company: Arizona Complete Health
Location: Chandler
Posted on: November 20, 2020

Job Description:

Job Description **PLEASE NOTE - CANDIDATE MUST RESIDE IN YAVAPAI COUNTY** Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider issues. Perform new provider orientations and educate providers regarding the provider manual, and contract requirements. Serves as a resource for department staff and provides training as need. * Serve as contact for provider inquires and track inquiries and response times. Draft contracts and manage contracting process to verify that contract deadlines are met * Monitor provider credentialing activities and contact providers for missing or incomplete information * Maintain and update provider databases to include key provider demographics and specialty provider information * Conduct administrative audits of provider agencies to evaluate provider contract adherence * Review, audit and price contract related pends to verify claims payment accuracy * Record, track, and monitor provider contract deliverables * Maintain the Provider Manual and update orientation materials as assigned. * Conduct new provider orientation and train providers on the Provider Manual updates and State policy updates * Create and process Vendor Agreements and Single Case agreements as assigned * Lead department process improvement efforts and initiatives * Monitor financial performance of contracts. * Serves as lead on projects as requested by department manager. * Ability to travel Education/Experience: Bachelor's Degree in healthcare administration, business administration or equivalent experience. 4+ years of provider relations or contracting experience in health care, managed care, Medicare or Medicaid services environment. Licenses/Certifications: Current state driver's license. 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.

Keywords: Arizona Complete Health, Chandler , Provider Relations & Contracting Specialist II -Care1st (Yavapai County), Other , Chandler, Arizona

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