Provider Engagement Account Manager
Centene Corporation
Provider Engagement Account Manager
Centene Corporation
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $55,100 - $99,000 per year
Job Level
JuniorMid-Level
About the role
- Maintain partnerships between the health plan and contracted provider networks
- Build client relations to ensure delivery of high level of care to members
- Engage with providers to align on network performance opportunities and solutions
- Drive optimal performance in contract incentives, quality, and cost utilization
- Conduct regular in-person visits with physicians to provide support and discuss performance metrics
- Focus on value-based care initiatives and performance-based agreements
- Use data analytics to track provider performance and offer actionable feedback
- Triage and resolve provider issues and claims inquiries
- Initiate data entry of provider demographic changes and educate providers on policies, referrals, claims, and EDI
- Perform provider orientations and ongoing provider education
- Manage network performance for assigned territory and complete special projects as assigned
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
- Ability to travel locally 4 days a week
- Experience using data analytics to track and monitor provider performance
- Consultative account management and issue resolution skills
