Talent.com
Provider Engagement Account Manager
Provider Engagement Account ManagerCentene • Richmond, VA, US
Provider Engagement Account Manager

Provider Engagement Account Manager

Centene • Richmond, VA, US
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
  • serp_jobs.job_card.part_time
job_description.job_card.job_description

Job Opportunity

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.

  • For this role we are seeking candidates who live in Oklahoma

Position Purpose

Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery of the highest level of care to our members. Engage with providers to align on network performance opportunities and solutions, and consultative account management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization.

  • Serve as primary contact for providers and act as a liaison between the providers and the health plan
  • Triages provider issues as needed for resolution to internal partners
  • Receive and effectively respond to external provider related issues
  • Investigate, resolve and communicate provider claim issues and changes
  • Initiate data entry of provider-related demographic information changes
  • Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics
  • Perform provider orientations and ongoing provider education, including writing and updating orientation materials
  • Manages Network performance for assigned territory through a consultative / account management approach
  • Evaluates provider performance and develops strategic plan to improve performance
  • Drives provider performance improvement in the following areas : Risk / P4Q, Health Benefit Ratio (HBR), HEDIS / quality, cost and utilization, etc.
  • Completes special projects as assigned
  • Ability to travel locally 4 days a week
  • Performs other duties as assigned
  • Complies with all policies and standards
  • Direct Provider Engagement : Conducts regular in-person visits with physicians to provide real-time support, discuss performance metrics, and identify opportunities for improvement in patient care and clinical practices.
  • Value-Based Care Model : Focuses on value-based care model initiatives, collaborating with physicians to identify and align to performance-based agreements that incentivize better patient outcomes, cost-efficiency, and quality care.
  • Performance Management : Uses data analytics to track and monitor provider performance, offering actionable feedback to help physicians optimize care delivery and meet key performance targets.
  • Education / Experience : Bachelor's degree in related field or equivalent experience. Two 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. Proficient in HEDIS / Quality measures, cost and utilization. Pay Range : $55,100.00 - $99,000.00 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

    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.

    Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

    serp_jobs.job_alerts.create_a_job

    Provider Engagement Account Manager • Richmond, VA, US

    Job_description.internal_linking.related_jobs
    Community Leasing Associate - Affordable

    Community Leasing Associate - Affordable

    Fairfield Residential • Chester, VA, United States
    serp_jobs.job_card.full_time
    Community Leasing Associate - Affordable.At Fairfield, we are proud to be a leader in the multifamily housing industry.We are passionate about creating exceptional apartment living.Among the most e...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Remote Customer Service Representative – Product Testing

    Remote Customer Service Representative – Product Testing

    GLOCPA • Petersburg, Virginia
    serp_jobs.filters.remote
    serp_jobs.job_card.full_time
    We’re looking for Customer Support Product Testers across the US to work from home and help top brands improve their products before they hit the market.serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Traveling Occupational Therapist - $1,746 per week

    Traveling Occupational Therapist - $1,746 per week

    Triage Staffing • Hopewell, VA, United States
    serp_jobs.job_card.full_time
    Triage Staffing is seeking a travel Occupational Therapist for a travel job in Hopewell, Virginia.Job Description & Requirements Specialty : Occupational Therapist Discipline : Therapy Start Date : 12...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Business Development Manager - Healthcare

    Business Development Manager - Healthcare

    Blue Signal Search • Richmond, VA, US
    serp_jobs.job_card.full_time
    Business Development Manager - Healthcare.Pediatric & Behavioral Health Services.Are you a natural connector with a talent for opening doors and building meaningful partnerships? We are seeking...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Account Manager

    Account Manager

    Jobot • Richmond, VA, US
    serp_jobs.job_card.permanent
    Competitive Salary & Commission Plan, Full Benefits.This Jobot Job is hosted by : Katie Whittington.Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume.Salary...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    PT / Physical Therapist - Home Health - $10k Sign On Bonus

    PT / Physical Therapist - Home Health - $10k Sign On Bonus

    BrightSpring Health Services • Colonial Heights, VA, United States
    serp_jobs.job_card.full_time
    Adoration Home Health and Hospice.Are you a Physical Therapist looking for a new opportunity? Adoration Home Health is seeking a passionate, dedicated Home Health PT to join our team in Colonial H...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Occupational Therapist - $1,961 per week

    Travel Occupational Therapist - $1,961 per week

    HealthCare Support • Hopewell, VA, United States
    serp_jobs.job_card.permanent
    Healthcare Support is seeking a travel Occupational Therapist for a travel job in Hopewell, Virginia.Job Description & Requirements. Travel Occupational Therapist Job.Hopewell, Virginia? Healthcare ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Occupational Therapist (OT) - $1,863 per week in Hopewell, VA

    Travel Occupational Therapist (OT) - $1,863 per week in Hopewell, VA

    AlliedTravelCareers • Hopewell, VA, US
    serp_jobs.job_card.full_time
    AlliedTravelCareers is working with TRS Healthcare to find a qualified Occupational Therapist (OT) in Hopewell, Virginia, 23860!. TRS Healthcare is seeking an experienced Rehab Unit Acute Occupation...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Flexible Remote Work – Get Paid to Share Your Opinions on Top Brands

    Flexible Remote Work – Get Paid to Share Your Opinions on Top Brands

    OCPA • Bowling Green, Virginia, us
    serp_jobs.filters.remote
    serp_jobs.job_card.part_time +1
    Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies. We guarantee 15-25 hours per week with an hourly pay of bet...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Occupational Therapist - $1,906 per week

    Travel Occupational Therapist - $1,906 per week

    Medical Solutions Allied • Hopewell, VA, United States
    serp_jobs.job_card.full_time
    Medical Solutions Allied is seeking a travel Occupational Therapist for a travel job in Hopewell, Virginia.Job Description & Requirements. We’re seeking talented healthcare professionals whose adven...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Occupational Therapist - $1,863 per week

    Travel Occupational Therapist - $1,863 per week

    TRS Healthcare • Hopewell, VA, United States
    serp_jobs.job_card.full_time
    TRS Healthcare is seeking a travel Occupational Therapist for a travel job in Hopewell, Virginia.Job Description & Requirements. Pay package is based on 8 hour shifts and 40 hours per week (subject ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Implementation Manager, Benefit Configuration

    Implementation Manager, Benefit Configuration

    Sentara • Richmond, VA, United States
    serp_jobs.job_card.full_time
    The Ops Support / Systems Administration manager manages all activities involving system benefit development and implementation, contract administration, coding compliance, fee schedule implementatio...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Pharmacy Manager - Sign-On Bonus and Relocation Available

    Pharmacy Manager - Sign-On Bonus and Relocation Available

    Walgreens • Petersburg, VA, United States
    serp_jobs.job_card.full_time
    Provides empathetic pharmacy consulting services to patients regarding the effective use of medications and drug interaction awareness. Offers preventive and clinical healthcare services, including ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Physical Therapist - $2,500 per week

    Travel Physical Therapist - $2,500 per week

    CompHealth • Colonial Heights, VA, United States
    serp_jobs.job_card.permanent
    Physical Therapist for a travel job in Colonial Heights, Virginia.Job Description & Requirements.Interested in this assignment? Or maybe you still have not found what you are looking for? Contact o...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Senior Account Manager, New York Construction

    Senior Account Manager, New York Construction

    Argonaut Management Services, Inc • Richmond, VA, United States
    serp_jobs.job_card.full_time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Physical Therapist - $2,500 per week

    Travel Physical Therapist - $2,500 per week

    CompHealth Inc. • Colonial Heights, VA, United States
    serp_jobs.job_card.permanent
    Physical Therapist for a travel job in Colonial Heights, Virginia.Job Description & Requirements.Interested in this assignment? Or maybe you still have not found what you are looking for? Contact o...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Remote Side Hustle Evaluator - Flexible Online Gig Work

    Remote Side Hustle Evaluator - Flexible Online Gig Work

    Finance Buzz • Woodford, Virginia, US
    serp_jobs.filters.remote
    serp_jobs.job_card.temporary
    Are you looking to earn extra income from the comfort of your home? We're seeking motivated individuals to explore and test a variety of remote side hustle opportunities featured on FinanceBuzz.Thi...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Occupational Therapist (Acute Care & Rehab) - $2,066 per week

    Travel Occupational Therapist (Acute Care & Rehab) - $2,066 per week

    Coast Medical Service • Hopewell, VA, United States
    serp_jobs.job_card.full_time
    Coast Medical Service is seeking a travel Occupational Therapist for a travel job in Hopewell, Virginia.Job Description & Requirements. Coast Medical Service is a nationwide travel nursing & allied ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted