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Provider Engagement Account Manager - Texas Hybrid
Manage Texas provider relationships and network performance for Centene’s health plan in a hybrid role. Improve quality, cost, utilization, claims, and contract incentive outcomes through consultative account management.
संयुक्त राज्य
टेक्सास$56,200 – $1,01,000 / वर्ष
हाइब्रिडपूर्णकालिकजूनियरमध्य स्तरआवश्यक भाषा: अंग्रेज़ीअकाउंट मैनेजरबिक्रीविवरण
- Maintain relationships between the health plan and contracted provider networks
- Build provider partnerships that support high-quality member care
- Work with providers to identify network performance opportunities and solutions
- Provide consultative account management and oversee issue resolution
- Improve contract incentive results, quality, cost, and utilization performance
- Act as the primary provider contact and liaison with the health plan
- Coordinate provider issue triage with internal teams
- Respond to external provider-related concerns
- Investigate, resolve, and communicate provider claim issues and updates
- Record changes to provider demographic information
- Train providers on referrals, claims submission, website tools, EDI solicitation, and related processes
- Conduct provider orientations and continuing education
- Create and maintain orientation materials
- Manage assigned territory performance through consultative account management
- Assess provider results and create strategic improvement plans
- Advance performance in Risk/P4Q, HBR, HEDIS/quality, cost, and utilization
- Complete special projects and other assigned responsibilities
- Follow all applicable policies and standards
आवश्यकताएँ
- U.S. work authorization without current or future employment-based visa sponsorship
- Bachelor’s degree in a related field or equivalent experience
- Two years of experience in managed care, medical groups, provider relations, quality improvement, claims, contracting utilization management, or clinical operations
- Project management experience in a medical group, IPA, or health plan environment
- Proficiency with HEDIS and quality measures, cost, and utilization
- Ability to travel locally four days per week
- Must reside in Texas
लाभ
- Competitive compensation
- Health insurance
- 401(k) plan
- Employee stock purchase plans
- Tuition reimbursement
- Paid time off and holidays
- Flexible remote, hybrid, field, or office work arrangements
- Additional incentives may form part of total compensation
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