Manager Contract Implementation - (CF11393)

Centene Corporation provides multi-line managed care programs and related services to individuals receiving benefits in Medicaid, including Supplemental Security Income (SSI) and the State Children's Health Insurance (SCHIP). Centene operates health plans in seven states. In addition, the Centene contracts with other healthcare organizations to provide specialty services including behavioral health, disease management, nurse triage and treatment compliance.

Position Purpose:Bridgeway Health Solutions provides services to low income older persons or people with disabilities through the ALTCS Program in Maricopa and Yuma/LaPaz counties. This position manages and oversees the implementation of all provider contracts.

Knowledge/Experience:
Requires a bachelor's degree in a related area, or equivalent experience, and 5-8 years of experience in provider relations/services, provider contracting and/or claims administration.

Competencies:
Manager: Integrity, Flexibility, Communication, Critical Thinking, Decision Making, Planning and Organizing, Building Strategic Working Relationships, Building a Successful Team, Technical and Professional Knowledge

Position Responsibilities:

oManage the health plan's workflow to assure timely and accurate completion, submission and implementation of contracts and set-up of providers.
oCoordinate the business process to ensure that deviations from contract standards have appropriate approval and can be effectively administered prior to execution.
oDocument and report all deviations from contract standards.
oDevelop, communicate, implement and maintain production and quality standards for staff.
oConduct internal audits of contracts, files and staff to ensure compliance with corporate standards and state/federal regulatory requirements.
oMonitor and sign-off on provider set-up and contract pricing and configuration processing to ensure adherence to corporate standards.
oResponsibility for user acceptance testing of all contract pricing and configuration changes.
oEstablish and refine, as appropriate, internal business processes to ensure that the quality of provider data and submissions meet IS' quality standards.
oActs as the IS interface for all questions regarding provider set-up and contract configuration and pricing.
oManage Contract Implementation Specialist position/area.


We are proud to be an EEO/AA employer M/F/D/V. We maintain a drug-free workplace and perform pre-employment substance abuse testing.

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