Talent.com
No longer accepting applications
Provider Engagement Account Manager

Provider Engagement Account Manager

CenteneSeattle, WA, US
17 hours ago
Job type
  • Full-time
  • Part-time
Job description

Provider Network Manager

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.

  • NOTE : For this role we are seeking candidates who live in Kentucky, specifically, Eastern / Northern Kentucky

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 • Seattle, WA, US

    Related jobs
    • Promoted
    Account Manager, Strategic Markets

    Account Manager, Strategic Markets

    Benco DentalSeattle, WA, United States
    Full-time
    Location : Seattle, WA, Portland, OR, or Sacramento, CA (proximity to a major airport is preferred for travel purposes).Account Manager, Strategic Markets. At Benco Dental, our company is our family,...Show moreLast updated: 30+ days ago
    • Promoted
    Employee Benefits Senior Account Manager

    Employee Benefits Senior Account Manager

    USI Insurance ServicesSeattle, Washington, US
    Full-time
    Manages complex Employee Benefit insurance accounts and services as their day-to-day contact.Not sure what skills you will need for this opportunity Simply read the full description below to get a ...Show moreLast updated: 30+ days ago
    • Promoted
    Oncology Account Manager

    Oncology Account Manager

    Idaho StaffingSeattle, WA, US
    Full-time
    Looking for a chance to make a meaningful difference in the oncology space? Taiho Oncology is on a mission : to improve the lives of patients with cancer, their families, and caregivers.Our "People ...Show moreLast updated: 7 days ago
    • Promoted
    Senior Account Manager- Dept of Energy / NNSA, Federal Civilian Sciences

    Senior Account Manager- Dept of Energy / NNSA, Federal Civilian Sciences

    Seattle StaffingSeattle, WA, US
    Full-time
    Account Manager Opportunity At Amazon Web Services.Amazon Web Services is seeking a self-starter to own revenue generation in the Federal Civilian Cloud Computing business.AWS is looking for a team...Show moreLast updated: 1 day ago
    • Promoted
    Senior Client Engagement Manager

    Senior Client Engagement Manager

    Microchip TechnologySeattle, WA, US
    Full-time
    Senior Client Engagement Manager (Cem).Are you looking for a unique opportunity to be a part of something great? Want to join a 20,000-member team that works on the technology that powers the world...Show moreLast updated: 30+ days ago
    • Promoted
    Oncology Account Manager

    Oncology Account Manager

    TAIHO ONCOLOGY INCSeattle, WA, United States
    Full-time
    Looking for a chance to make a meaningful difference in the oncology space? Taiho Oncology is on a mission : to improve the lives of patients with cancer, their families, and caregivers.Our "People ...Show moreLast updated: 4 days ago
    • Promoted
    Engagement Manager

    Engagement Manager

    Diverse LynxBellevue, WA, US
    Full-time
    Drive pre-sales activities, solution designing.Own the solution and deliver the pitch at client orals.Engage deeply with client during sales cycle. Collaborate with project teams to ensure seamless ...Show moreLast updated: 30+ days ago
    • Promoted
    Provider Partnerships Manager (Territory Sales Manager)

    Provider Partnerships Manager (Territory Sales Manager)

    NourishSeattle, WA, US
    Full-time
    Nourish is on a mission to improve people's health by making it easy to eat well.Nutrition-related chronic disease is the largest and most overlooked crisis in the world.Food can be medicine : w...Show moreLast updated: 30+ days ago
    • Promoted
    Account Manager - Employee Benefits

    Account Manager - Employee Benefits

    Seattle StaffingSeattle, WA, US
    Full-time
    Responsible for providing customer service and overall service of assigned customers and / or policies, soliciting of new business on existing accounts and support of Producer-led new business effort...Show moreLast updated: 1 day ago
    • Promoted
    Sr Engagement Manager, AWS Professional Services

    Sr Engagement Manager, AWS Professional Services

    Seattle StaffingSeattle, WA, US
    Full-time
    Engagement Manager for AWS Professional Services.The Amazon Web Services Professional Services (ProServe) team is seeking a highly skilled and versatile Engagement Manager (EM) to join our team and...Show moreLast updated: 1 day ago
    • Promoted
    Named Account Manager

    Named Account Manager

    Seattle StaffingSeattle, WA, US
    Full-time
    Named Account Manager, Healthcare.Our mission at Palo Alto Networks is to be the cybersecurity partner of choice, protecting our digital way of life. Our vision is a world where each day is safer an...Show moreLast updated: 1 day ago
    • Promoted
    Strategic Account Manager

    Strategic Account Manager

    Washington StaffingSeattle, WA, US
    Full-time
    Astound is a leading provider of internet, WiFi, mobile, and TV services, dedicated to connecting communities and empowering lives through innovative technology. We also keep businesses connected wi...Show moreLast updated: 8 days ago
    • Promoted
    Associate Account Manager, Personal Lines

    Associate Account Manager, Personal Lines

    The Partners GroupRenton, WA, United States
    Full-time
    Find your place at The Partners Group, a purpose-driven company committed to making a difference in our community through our work and inspiring others to do the same. TPG's success is driven by a c...Show moreLast updated: 30+ days ago
    • Promoted
    Named Account Manager-Healthcare WA / OR / ID

    Named Account Manager-Healthcare WA / OR / ID

    Seattle StaffingSeattle, WA, US
    Full-time
    Sales Professional Opportunity.Proofpoint is looking for a high performing sales professional to join their Named Account team selling to Enterprise Healthcare accounts. If you are looking to join a...Show moreLast updated: 1 day ago
    • Promoted
    Private Client Account Manager

    Private Client Account Manager

    Brown & BrownSeattle, WA, US
    Full-time
    Private Client Account Manager.Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown is seeking a ...Show moreLast updated: 20 days ago
    • Promoted
    Strategic Account Manager, Central - OH

    Strategic Account Manager, Central - OH

    SanofiSeattle, WA, US
    Full-time
    Strategic Account Manager, Central - OH.The US Rare Disease, Strategic Account Manager will play a critical role in driving sales and optimizing care pathways for cross-lysosomal storage disease (x...Show moreLast updated: 1 day ago
    • Promoted
    Associate Account Manager BioT (Seattle)

    Associate Account Manager BioT (Seattle)

    Smith+NephewSeattle, WA, US
    Full-time
    Associate Account Manager Advanced Wound Biotissue.At Smith+Nephew we design and manufacture technology that takes the limits off living. The Associate Account Manager, Biotissue is all about makin...Show moreLast updated: 22 days ago
    • Promoted
    Account Specialist, Starlink Enterprise Account Management

    Account Specialist, Starlink Enterprise Account Management

    SpaceXRedmond, WA, US
    Full-time
    Account Specialist, Starlink Enterprise Account Management.SpaceX was founded under the belief that a future where humanity is out exploring the stars is fundamentally more exciting than one where ...Show moreLast updated: 30+ days ago