Provider Engagement Account Manager

Centene Corporation • Oklahoma City, OK • 23h ago

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 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: $56,200.00 - $101,000.00 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

Go to Apply

Leader in Development | Human Resources (Center of Excellence)

Omni Hotels • Oklahoma City, OK • 1d ago

Management & Administrative

Location Come and join our team at this 605-room convention center hotel in the heart of downtown Oklahoma City. Our luxury hotel is located next to the Paycom Center(OKC Thunder), the Oklahoma Convention Center and acro...

1d ago

Go to Apply

Supply Chain and Operations Consulting - SAP Extended Warehouse Management Manager

Accenture • Oklahoma City, OK • 1d ago

Management & Administrative

We Are:Supply Chain & Operations, and we move fast, think fast, and work fast. Our Fortune 500 clients require digital transformation across warehouse and logistics operations, and we deliver solutions using SAP EWM...

1d ago

Go to Apply

Regional Sales Manager

Oracle • Oklahoma City, OK • 1d ago

Management & Administrative

Job Description The primary focus of an Oracle Inside Sales Team Manager is to plan, manage and develop a team of Inside Sales Representatives. Career Level - M2 Responsibilities Manages a team of telesales representativ...

1d ago

Go to Apply

Vice President, Power Market

J.E. Dunn Construction Company • Oklahoma City, OK • 1d ago

Management & Administrative

Vice President, Power Market Location: Atlanta, GA, US, 30339Indianapolis, IN, USWaco, TX, USLas Vegas, NV, USHillsboro, OR, US, 97124Clarksville, TN, USTulsa, OK, USLake Charles, LA, USSt. Louis, MO, US, 63101Fort Wayne...

1d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.