Manager, Provider Relations

Company: Fidelis Care - New Jersey
Location: Iselin
Posted on: February 19, 2025

Job 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: Responsible for maintaining existing and developing new provider relations, and assisting with contracting activities

• Manage the staff in contracting area including work flow, training and communication standards
• Manage day-to-day provider relations activities and provider relations department
• Develop, implement and maintain production and quality standards for the contracting staff
• Monitor and analyze costs and prepare departmental budget
• Initiate and execute standard physician and ancillary provider contracts
• Coordinate all pre-contract activities with providers such as, site visits, credentialing, orientation to contractual requirements, etc.
• Maintain contracts and correspondence files in organized and accessible manner for all providers
• Prepare and analyze information to evaluate the need for additional health plan providers
• Manage and coordinate customized provider contracts and hospital contracts
• Participate in physician and ancillary provider contracting and provider relations in foreign state markets through implementation and startup phasesEducation/Experience: Bachelor's degree in related field or equivalent experience. 4+ years of managed care, health delivery system and/or project and staff management experience. Experience with state and federal health programs such as Medicaid and Medicare. Provider relations/contracting experience including solid communication and negotiation skills. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.Pay Range: $86,000.00 - $154,700.00 per year
  Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
  
  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

Keywords: Fidelis Care - New Jersey, New York , Manager, Provider Relations, Executive , Iselin, New York