Network Development Specialist

at Centene Corporation in Burr Ridge, Illinois, United States

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: Monitor and oversee network development efforts including facilitating network transitions and developing and maintaining the network analysis and network development plans. Monitor network performance.

- Develop and maintain all required State and health plan network reports including GeoAccess analysis, network readiness reports, etc.

- Develop and maintain provider transition spreadsheets.

- Review provider data reports and monitor network adequacy to provide recommendations for network enhancements

- Assist with the completion of annual and quarterly network analyses.

- Track and monitor all activities of the network development plans.

- Prepare network data for internal and external customers.

- Implement project plans and assist with project development efforts.

- Coordinate the completion of Arizona System of Care Plans.

- Work with providers to verify accuracy and timeliness of data submissions.

- Review provider profiles, implement and review corrective action plans as needed, and submit provider service delivery reports.

- Monitor and maintain internal and provider data integrity and facilitate data clean up.

- Create provider, claims, and membership data reports and data reconciliation

- Provide formal provider staff trainings as needed.

Education/Experience: Bachelor’s degree or equivalent experience. 3+ years of experience, preferably in the healthcare or insurance industry, including experience with Microsoft Office applications, specifically Excel, MS Project Management, and Access. Provider relations experience preferred. Project Management and statistical analysis experience preferred.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.

TITLE: Network Development Specialist

LOCATION: Burr Ridge, Illinois

REQNUMBER: 1451373

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Job Posting: JC248232576

Posted On: Sep 22, 2023

Updated On: Oct 16, 2023

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