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Centene Corporation
Centene Corporation
ConsultingHealthcareInsurance
Centene Corporation is a healthcare and insurance company focused on government-sponsored coverage and community health. Its services include Medicaid, Medicare, Health Insurance Marketplace plans, and TRICARE support for military communities. Centene combines localized care delivery with partnerships with nonprofit organizations to address the needs of the members it serves. The company also incorporates environmental responsibility and ethical governance into its approach to operating and supporting communities.
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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.

USUnited StatesTXTexas
$56,200 – $101,000 / year
HybridFull-timeJuniorMiddleEnglish RequiredAccount ManagerSales

Description

  • 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

Requirements

  • 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

Benefits

  • 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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