Senior Provider Engagement Network Specialist

Centene Corporation

. Assure providers are set up accurately in the provider information system for state reporting, claims payment, and directories .

Posted 9/21/2026full-timeRemote • New Jersey • United StatesSenior💰 $56,200 - $101,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in provider services, including managing provider relationships, resolving complex data issues, and administering contractual agreements. Proficient in provider information systems and experienced in a managed healthcare environment.

Highest-signal resume keywords

Provider Services ExperienceProvider Information SystemsContract ManagementClaims ResolutionHealthcare Degree

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Provider Data ManagementContract LoadingEligibility VerificationGrievance ResolutionClaims Processing

Soft Skills

CommunicationRelationship ManagementProblem SolvingTraining and Education

Industry Keywords

Managed HealthcareProvider ContractingBenefits InterpretationProvider RelationsState Reporting

About the role

Key responsibilities & impact

Assure providers are set up accurately in the provider information system for state reporting, claims payment, and directories
Manage state deliverables, network reporting, directories, and claims payment resolution related to provider setup
Support external provider representatives in resolving provider data issues
Research and respond to provider-related issues
Act as internal and external liaison for provider networking
Maintain relationships with participating physicians, physician groups, multi-specialty groups, and ancillary providers
Act as account manager and gatekeeper for assigned groups
Administer contractual provider relationships and maintain accurate provider databases
Provide training, education, and information to providers
Research, analyze, and resolve complex contract, claims, eligibility, appeals, grievance, and provider data issues
Serve as primary liaison between assigned providers and the health plan
Act as department subject matter expert
Perform other duties as assigned and comply with policies and standards

Requirements

What you’ll need

Must reside in New Jersey
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Bachelor’s degree in healthcare related field or equivalent experience required
5+ years of provider services experience required
Experience in a managed health care environment
Exposure to provider contracting, servicing benefits interpretation, and internal operations of provider relations
Experience with provider information systems, provider data, contract loading, contract rates and language, appeals, grievances, eligibility, claims, and data issue resolution

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
Stock purchase plan
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation