What are the responsibilities and job description for the Healthcare Provider Contract Specialist position at Sunshine State Health Plan?
Transform the lives of our members by negotiating and managing healthcare provider contracts with Sunshine State Health Plan. As a Clinical Relations Coordinator, you will be responsible for building and maintaining strong relationships with healthcare providers in the Panhandle region of Florida.
About the Role
This is a remote position that requires occasional local travel (10% - 25%) for provider visits in the field. You must reside in the Panhandle region of Florida to be considered for this role.
Responsibilities
- Negotiate and manage hospital, physician, and ancillary service agreements in accordance with corporate, health plan, and state guidelines.
- Develop and maintain a robust provider network plan, identifying potential providers and initiating contact to build strong relationships.
- Collaborate with internal departments and contracted providers to ensure contract compliance and accurate claims adjudication.
- Evaluate and monitor providers' performance standards and financial performance of contracts.
- Assist with credentialing activities and facilitate the organization of provider focus groups.
Education/Experience: Bachelor's degree in Healthcare Administration, Business Administration, Marketing, or related field, or equivalent experience. 2 years of contracting, provider relations, or other related experience preferably in a healthcare, managed care, or insurance-related environment.
Pay Range: $55,100.00 - $99,000.00 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.
Salary : $55,100 - $99,000
