Contract Negotiator (Clinical) - Must be RN

Position Purpose: Coordinate and negotiate Single Case Agreements (SCAs) with hospital, physicians and ancillary service providers that are in accordance with corporate, health plan and State guidelines

Manages SCA negotiations with non-participating providers for all lines of business (hospitals, physicians, physician groups, specialty providers, ancillaries, etc.)

Assist with specific contracting strategy for SCAs and redirection efforts to participating providers

Coordinate efforts with local and corporate Medical Management teams for complex SCA, benefit and service needs including transplantation and clinical trials

Evaluate and monitor SCAs and completes required internal and external reports

Develop and maintain Center of Excellence tools that can be utilized by other internal departments

Collaborates with internal departments and providers to implement and SCAs

Provides insight to contracting teams regarding network provider capacity issues and/or gaps

As a resource and liaison for clinical benefit interpretation for contracting team

May require up to 10% travel

Education/Experience: Graduate from an Accredited School of Nursing. 3 years of nursing experience, including 1 years of experience in a managed care environment. Contracting, case management or medical management experience preferred.

Licenses/Certifications: Current state's RN license

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.