Provider Engagement Account Manager

Centene Corporation

Account Manager responsible for provider engagement and performance management within health plan networks. Building partnerships and ensuring quality care delivery to members while addressing provider issues.

Posted 6/2/2026full-timeRemote • Montana • 🇺🇸 United StatesJuniorMid-Level💰 $56,200 - $101,000 per yearWebsite

About the role

Key responsibilities & impact

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.
Investigate, resolve and communicate provider claim issues and 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.

Requirements

What you’ll need

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

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

managed careprovider relationsquality improvementclaimscontractingutilization managementclinical operationsproject managementHEDISquality measures

Soft Skills

client relationscommunicationproblem-solvingconsultative account managementissue resolutioneducationliaisontriage

Certifications

Bachelor’s degree