Hybrid Provider Engagement Account Manager – State

at Centene Corporation

• Job title: Provider Engagement Account Manager – State
• Job type: Full Time
• Experience level: Junior, Mid level
• Salary: $27 - $49 per hour
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Los Angeles, United States

About the role

• Provider Engagement Account Manager focusing on building client relations and managing provider networks for a health plan. Engaging with providers and driving optimal performance in care delivery and contract performance.

Responsibilities

• Maintain partnerships between the health plan and contracted provider networks.
• Build client relations to ensure delivery of care to members.
• Engage with providers on network performance opportunities and solutions.
• Drive optimal performance in contract incentive performance, quality, and cost utilization.
• Serve as primary contact for providers and liaison between providers and health plan.
• Triage provider issues as needed for resolution to internal partners.
• Receive and respond to external provider related issues.
• Investigate, resolve and communicate provider claim issues and changes.
• Educate providers regarding policies and procedures related to referrals and claims submission.
• Perform provider orientations and ongoing provider education.

Requirements

• 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.

Benefits

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