Talent.com
Provider Engagement Account Manager

Provider Engagement Account Manager

CenteneRichmond, VA, US
23 hours ago
Job type
  • Full-time
  • Part-time
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

    Create a job alert for this search

    Engagement Manager • Richmond, VA, US

    Related jobs
    • Promoted
    Drive with DoorDash - Flexible Onboarding

    Drive with DoorDash - Flexible Onboarding

    DoorDashProvidence Forge, VA, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show moreLast updated: 4 days ago
    • Promoted
    Physical Therapist (PT) - Home Health - Part Time

    Physical Therapist (PT) - Home Health - Part Time

    Enhabit Home Health & HospiceCharles City, VA, US
    Full-time +1
    Are you in search of a new career opportunity that makes a meaningful impact? If so, now is the time to find your calling at Enhabit Home Health & Hospice. As a national leader in home-based care, E...Show moreLast updated: 1 day ago
    • Promoted
    Engagement Manager Remote

    Engagement Manager Remote

    SBI GrowthRichmond, VA, US
    Remote
    Full-time
    When you join SBI as an Engagement Manager, you are joining a firm that is on the forefront of driving innovative go-to market transformations helping clients solve their revenue growth challenges....Show moreLast updated: 1 day ago
    • Promoted
    Licensed Therapist (LCSW, LPC, LMFT)

    Licensed Therapist (LCSW, LPC, LMFT)

    LifeStance HealthThornburg, VA, US
    Full-time
    At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make lives better. Our mission is to help people lead healthier, more fulfilling lives...Show moreLast updated: 30+ days ago
    • Promoted
    Restaurant Delivery - Onboarding / Onboard

    Restaurant Delivery - Onboarding / Onboard

    DoorDashRuther Glen, VA, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show moreLast updated: 4 days ago
    • Promoted
    B2G Senior Marketing Manager

    B2G Senior Marketing Manager

    Government Business ResultsTappahannock, VA, US
    Full-time
    The Senior Marketing Manager provides expert marketing strategy and execution support for public sector marketing programs and activities. This role brings deep B2G (business-to-government) marketin...Show moreLast updated: 1 day ago
    • Promoted
    • New!
    Occupational Therapist

    Occupational Therapist

    Encompass Health Rehabilitation Hospital of FredericksburgPotomac Mills, VA, US
    Full-time +1
    Occupational Therapist Career Opportunity.Your Calling, Close to Home and Heart.Are you in pursuit of a career that's more than a job, one that aligns with your heart and community? We believe ...Show moreLast updated: 15 hours ago
    • Promoted
    Delivery Driver - Flexible Onboarding

    Delivery Driver - Flexible Onboarding

    DoorDashTappahannock, VA, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show moreLast updated: 4 days ago
    • Promoted
    United States Border Patrol Agent

    United States Border Patrol Agent

    U.S. Customs and Border ProtectionTappahannock, VA, US
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 4 days ago
    • Promoted
    Nurse Practitioner In-home Health Evaluations- Contract NP Position- $2500-$4000 / Week

    Nurse Practitioner In-home Health Evaluations- Contract NP Position- $2500-$4000 / Week

    Northeast Healthcare RecruitmentKing William, VA, US
    Full-time
    Board-Certified Nurse Practitioner - In-Home Health Evaluations.Build trusted relationships while helping people re-engage with their health. Additional pay-per-test compensation.Monday through Sund...Show moreLast updated: 30+ days ago
    • Promoted
    Share Your Opinions. Earn Rewards.

    Share Your Opinions. Earn Rewards.

    Opinion EdgeLaurel, VA, US
    Full-time
    Join Opinion Edge today and get paid for your insights! Take short surveys on the topics that matter to you and earn rewards for every completed survey. Sign up now and start turning your voice into...Show moreLast updated: 2 days ago
    • Promoted
    Engagement Manager

    Engagement Manager

    Jobs for HumanityRichmond, VA, US
    Full-time +1
    Talentism helps leaders learn and adapt faster than the competition.Talentism's IP and methodology have been delivered to over 800 organizations, and are built on disciplines including neuroscience...Show moreLast updated: 23 hours ago
    • Promoted
    • New!
    Dashers - Sign Up and Start Earning

    Dashers - Sign Up and Start Earning

    DoorDashTappahannock, VA, US
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show moreLast updated: 14 hours ago
    • Promoted
    Restaurant Delivery - Flexible Onboarding

    Restaurant Delivery - Flexible Onboarding

    DoorDashProvidence Forge, VA, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show moreLast updated: 4 days ago
    • Promoted
    Drive with DoorDash - Onboarding / Onboard

    Drive with DoorDash - Onboarding / Onboard

    DoorDashTappahannock, VA, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show moreLast updated: 4 days ago
    • Promoted
    Pharmacy Manager - Sign On Bonus and Relocation Assistance Available

    Pharmacy Manager - Sign On Bonus and Relocation Assistance Available

    WALGREENSPetersburg, VA, US
    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 ...Show moreLast updated: 1 day ago
    • Promoted
    RN - Home Health

    RN - Home Health

    Enhabit Home Health & HospiceCHARLES CITY, VA, US
    Full-time
    Are you in search of a new career opportunity that makes a meaningful impact? If so, now is the time to find your calling at Enhabit Home Health & Hospice. As a national leader in home-based care, E...Show moreLast updated: 3 days ago
    • Promoted
    Delivery Driver - Onboarding / Onboard

    Delivery Driver - Onboarding / Onboard

    DoorDashRuther Glen, VA, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show moreLast updated: 4 days ago