Director, Provider Relations

at  Fidelis Care

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’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Oversee the Provider Relations department including negotiations and administering organization policies and procedures.

• Oversee the Provider Relations department to ensure in compliance with company policies and standards, government laws, regulations and contracting standards.
• Develop, implement and monitor policies and procedures.
• Develop tactical plans to align strategies and technologies with future needs.
• Effectively manage budget and all resources for short and long-term needs.
• Prepare and analyze reports on departmental and organizational activities and recommend improvements.
• Ensure timely Provider set up processing, auditing and distribution of Provider Relations data management.
• Create effective organizational structure and develop staff skills and competencies.
• Develop and oversee the training program for the Provider Relations Department.

Education/Experience: Bachelor’s degree in a Business Administration, Healthcare Administration, related field or equivalent experience. 7+ years of provider relations or contracting experience in a managed care or insurance environment, preferably in Medicare or Medicaid. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
License/Certification: Valid driver’s license.
For Fidelis Care only: Must have valid driver license, personal vehicle and ability to travel.
Pay Range: $113,800.00 - $210,500.00 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. Actual pay will be adjusted based on an individual’s skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
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

• Oversee the Provider Relations department to ensure in compliance with company policies and standards, government laws, regulations and contracting standards.
• Develop, implement and monitor policies and procedures.
• Develop tactical plans to align strategies and technologies with future needs.
• Effectively manage budget and all resources for short and long-term needs.
• Prepare and analyze reports on departmental and organizational activities and recommend improvements.
• Ensure timely Provider set up processing, auditing and distribution of Provider Relations data management.
• Create effective organizational structure and develop staff skills and competencies.
• Develop and oversee the training program for the Provider Relations Department