Provider Engagement Account Executive
Texas State Library and Archives CommisionNew York, NY, United States13 hours ago
Job type
- Full-time
- Permanent
Job descriptionDrive value-based care model initiatives and align providers with performance-based agreements. Use data analytics to track provider performance; offer actionable insights to improve quality, cost efficiency, and outcomes. Evaluate provider performance and create strategic plans for improvement. Investigate and resolve high-dollar and high-volume claim issues. Educate providers on policies, referral processes, claims submission, EDI, and platform usage. Identify inefficiencies and implement corrective measures to prevent recurring issues. Present Health Benefit Ratio (HBR) analyses and create detailed reports for Joint Operating Committee (JOC) meetings. Develop performance dashboards, reports, and strategic documentation as required. Act as a lead and mentor to external representatives; coach and train field staff as needed. Collaborate cross-functionally across health plan teams and external provider groups. Support network management strategies to improve provider satisfaction and retention. Travel locally 4 days per week. Perform other duties as assigned and comply with all company policies and standards. Bachelor's degree in a related field OR equivalent experience. Master's preferred : MPH, MHA, or MBA. 5+ years experience in : Provider relations or clinical operations Quality improvement or utilization management Medical group / IPA / health plan environment Strong project management experience within healthcare organizations. Ability to influence executive-level leaders and achieve performance targets. Strong understanding of : Value-based performance Cost and utilization drivers Ability to synthesize and communicate complex issues to multiple organizational levels.
Provider Engagement Account Executive
Location : Queens, NY & The Bronx, NY
Work Type : Hybrid (Remote + 30-50% Field Travel)
Job Type : Full-time | Permanent
Industry : Healthcare
Salary Range : $115,000 - $120,000 / year
Position Overview
The Provider Engagement Account Executive develops strategic partnerships between Centene's health plan and contracted provider networks to ensure high-quality care delivery for members. This role focuses on value-based care initiatives, provider performance optimization, and relationship management at both operational and executive levels. The position is hybrid, requiring frequent local travel (4 days / week) to meet with providers across Queens and the Bronx.
Key Responsibilities
Provider Relationship & Engagement
- Conduct regular in-person visits with physicians to provide real-time support and performance discussions.
- Build strong relationships with provider organizations, including C-suite leaders.
- Serve as the primary escalation point for provider concerns, ensuring timely resolution.
Value-Based & Performance Management
Problem Resolution & Operational Support
Data Reporting & Presentations
Leadership & Collaboration
General
Required Qualifications
Managed care
HEDIS & quality measures
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Account Executive • New York, NY, United States
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