Provider Relations Consultant

We exist for workers and their employers -- who are the backbone of our economy.  That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.

Centivo is looking for an individual with provider relations experience to join our team as a Network Relations Consultant!

As a Network Relations Consultant, you will act as a primary resource for assigned providers and groups to establish, oversee, and maintain positive relationships by assisting with/or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.

Responsibilities Include:

Working under the guidance of the Director of Provider Relations, you will:

• Coordinate outreach and ensure providers have smooth onboarding experiences as they join the Centivo network.

• Educate\Re-educate providers as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, policies, and procedures.

• Monitor service capabilities and collaborate cross-functionally to ensure that the needs of constituents are met and that escalated issues related but not limited to, claims payment, contract interpretation or parameters, and accuracy of provider contract or demographic information are resolved.

• Work with provider partners to ensure high quality and current provider data.

• Manage complex initiatives around contracting, data collection and validation, and provider credentialing.

• Support or assist with operational activities that may include, but are not limited to, database roster management, and contract coordination.

• Perform credentialing support activities as needed.

Qualifications:

You should have:

• 3+ years of provider and/or network relations experience

• Prior experience working with and interacting with healthcare providers and facilities

• Intermediate Excel experience is required

• High school diploma or equivalent required

• And although it’s not required, we’d love it if you have negotiating experience

Work Location:

• This position is remote but must be a WI based person

Centivo Values:

• Resilient – This is wicked hard. There is no easy button for healthcare affordability. Luckily, the mission makes it worth it and sustains us when things are tough. Being resilient ensures we don’t give up.

• Uncommon - The status quo stinks so we had to go out and build something better. We know the healthcare system. It isn't working for members, employers, and providers. So, we're building it from scratch, from the ground up. Our focus is on making things better for them while also improving clinical results - which is bold and uncommon.

• Positive – We care about each other. It takes energy to do hard stuff, build something better and to be resilient and unconventional while doing it. Because of that, we make sure we give kudos freely and feedback with care. When our tank gets low, a team member is there to be a source of new energy. We celebrate together. We are supportive, generous, humble, and positive.

Who we are:

Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com.

Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.