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\xe2\x80\x99ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Oklahoma Complete Health, a Centene company, is committed to providing quality healthcare solutions to transform the health of Oklahomans.

At Oklahoma Complete Health, we are community advocates and change-makers in search of an inclusive culture grounded by our commitment to work-life balance, competitive compensation, and continuous career development. Join us and be a part of a collaborative, growing network of innovative thinkers delivering solutions at the local level.

***Must Reside in Oklahoma***

Position Purpose: Assist with all vendor activity, including but not limited to dental, ancillary, pharmacy and vision vendors for the Health Plan

• Assit with vendor utilization including work flows for coordinating services with the Health Plan
• Analyze vendor data and complete required reports for the health plan, Corporate and state
• Perform as a key account manager for the Health Plan to coordinate with high priority providers and vendors
• Coordinate with Medical Management, Member Services and Provider Services to educate and communicate expectations, performance and procedures to vendors
• Respond to provider related database information requests and concerns
• Ensure operation integrity, including compliance with all policies and procedures for the Health Plan including adherence to state contract and guidelines
• Request and/or assist in the development of correction action plans for standards that are not met by the vendor
• Serve as a point of contact and resource for the business unit and vendors for all credentialing inquiries and issues
• Ensure compliance with NCQA, URAC, federal, state and payor standards

Education/Experience: Bachelors\xe2\x80\x99 degree in Public Health, Business, related field or equivalent experience. 3+ years of healthcare management experience, preferably in vendor managed care or the health insurance field. Experience with reporting and analyzing data preferred. Strong Excel skills and working with a variety of software data programs preferred. Project management experience is a plus.

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.

Oklahoma Complete Health