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 11/3/2026full-timeRemote • Pennsylvania • 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 contract and claims issues, and ensuring accurate provider data management. Strong background in healthcare operations and provider contracting within a managed care environment is essential.

Highest-signal resume keywords

Provider Services ExperienceProvider ContractingClaims Payment ResolutionHealthcare OperationsRelationship Management

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 LoadingFinancial Responsibility InterpretationBenefits InterpretationIssue Resolution

Soft Skills

CommunicationTrainingLiaison SkillsProblem-Solving

Tools & Technologies

Provider Information System

Industry Keywords

Managed Health CareProvider RelationsHealthcare FieldContractual RelationshipsEligibility

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 provider groups
Administer contractual provider relationships and oversee accurate, current provider databases
Provide training, education, and information to providers
Research, analyze, and resolve complex issues involving contract loading, financial responsibility interpretation, contract rates and language, appeals, grievances, and eligibility
Serve as primary liaison between assigned providers and the health plan
Resolve complex provider contract, claims, and data issues
Act as department subject matter expert
Perform other assigned duties
Comply with all policies and standards

Requirements

What you’ll need

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
Exposure to servicing benefits interpretation
Exposure to internal operations of provider relations
Candidates must be in Western/Southwestern Pennsylvania
Occasional travel for meetings required

Benefits

Comp & perks

Health insurance
401K plan
Stock purchase plans
Tuition reimbursement
Paid time off
Holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation
Equal opportunity employer committed to diversity