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 10/23/2026full-timeRemote • Florida • 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 information systems, resolving complex provider-related issues, and maintaining strong relationships with healthcare providers. Proficient in contract interpretation, claims payment resolution, and compliance with healthcare policies.

Highest-signal resume keywords

Provider Services ExperienceProvider Information SystemsContract InterpretationClaims Payment ResolutionHealthcare Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider ContractingClaims PaymentFinancial Responsibility InterpretationContract LoadingAppeals ManagementGrievances HandlingEligibility VerificationState ReportingProvider DatabasesDirectory Management

Soft Skills

Effective CommunicationProblem SolvingRelationship ManagementTraining and EducationLiaison Skills

Industry Keywords

Managed HealthcareHealthcare Provider RelationsProvider NetworkingMulti-Specialty GroupsAncillary Providers

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 multiple 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 effectively to provider-related issues
Act as internal and external liaison for provider networking
Maintain working relationships with participating physicians, physician groups, multi-specialty groups, and ancillary providers
Act as account manager and gatekeeper for assigned provider groups
Administer and operate contractual provider relationships
Oversee accurate and current provider databases
Provide training, education, and information to providers
Research, analyze, and resolve complex problems involving contract loading, financial responsibility interpretation, contract rate and language interpretation, appeals, grievances, and eligibility
Serve as primary point of contact between assigned providers and the health plan
Resolve complex provider contract, claims, and data issues
Act as department subject matter expert
Perform other duties as assigned
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, servicing benefits interpretation, and internal operations of provider relations
Experience with provider information systems, provider databases, state reporting, claims payment, directories, contract loading, financial responsibility interpretation, contract rates and language, appeals, grievances, and eligibility

Benefits

Comp & perks

Health insurance
401K
Stock purchase plans
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
Equal opportunity employer committed to diversity