Senior Provider Engagement Account Manager

5 days ago

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Centene Corporation

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Contracting • Network Development • Managed Care

10,000+

Description

• Develop strategic partnerships between the health plan and contracted provider networks • Engage with providers to align on network performance opportunities and solutions • Drive optimal performance in contract incentive performance, quality, and cost utilization • Participate in the development of network management strategies • Serve as primary contact for providers and act as a liaison between the providers and the health plan • Identify and deliver solutions to providers concerns and issues as needed • Investigate, resolve and communicate provider claim issues and changes • Engage with and educate providers regarding policies and procedures related to referrals and claims submission • Perform provider orientations and ongoing provider education • Manages Network performance for assigned territory through a consultative/account management approach • Evaluates provider performance and develops strategic plan to improve performance • Drive provider performance improvement in various areas

Requirements

• Bachelor’s degree in related field or equivalent experience • Three or more years of managed care or medical group experience, provider relations, quality improvement, claims, contracting, utilization management, or clinical operations • Project management experience at a medical group, IPA, or health plan setting • Strong communication and presentation skills • Proficient in HEDIS/Quality measures, cost and utilization

Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules