Centene Corporation
Centene Corporation
Centene Corporation — үкімет қаржыландыратын медициналық сақтандыруға және қоғам денсаулығына бағытталған денсаулық сақтау және сақтандыру компаниясы. Оның қызметтеріне Medicaid, Medicare, медициналық сақтандыру маркетплейсінің жоспарлары және әскери қауымдастықтарға арналған TRICARE қолдауы кіреді. Centene қызмет көрсететін мүшелердің қажеттіліктерін қанағаттандыру үшін жергілікті медициналық көмек көрсетуді коммерциялық емес ұйымдармен серіктестікпен ұштастырады. Компания сондай-ақ өз қызметін жүргізу және қауымдастықтарды қолдау тәсіліне экологиялық жауапкершілік пен этикалық басқару қағидаттарын енгізеді.

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.

Сипаттама

  • 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

Талаптар

  • 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

Артықшылықтар

  • 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

Ұқсас жұмыс орындары

Ultralytics

Embedded Computer Vision Engineer at Ultralytics (On-site, Spain)

Ultralytics

Bring Ultralytics YOLO models from PyTorch into production on edge devices. Build runtime integrations and tune deployment for CPU, GPU, NPU, and SoC platforms.

Ашу
Pearson VUE

Administrative Support Associate

Pearson VUE

Support Pearson VUE’s operational systems, records and management reporting through accurate data administration and project tracking. This full-time hybrid role is based in the United Kingdom, with occasional access to the Hellaby site helpful.

Ашу
Niantic Spatial, Inc.

Computer Vision AI Engineer

Niantic Spatial, Inc.
201 – 500 Қызметкерлер
КонсалтингҚорғанысЛогистика

Train computer vision localization models for Niantic Spatial’s physical AI and geospatial platform. Build data pipelines, evaluation benchmarks, and production inference systems.

Ашу
UR Ventures

Medical Center Call Center Representative II

UR Ventures
11 – 50 Қызметкерлер
B2BБілім беруҒылым

Support University of Rochester Medical Center patients by answering questions and coordinating appointments, registration, and referrals. Handle confidential medical information and route urgent requests appropriately.

Ашу
Baxter International Inc.

Remote Technical Support Specialist – Baxter Infusion Systems

Baxter International Inc.

Provide first-line support for Baxter infusion pumps, software, and connected healthcare technology. Troubleshoot customer problems and manage cases to help keep systems running.

Ашу
Ovation Law Firm

Remote Bilingual Call Center Sales Intake Specialist

Ovation Law Firm

Qualify personal injury inquiries, document case details, and connect prospective clients with partner legal teams. This remote role handles high-volume English and Spanish calls, live transfers, and follow-ups.

Ашу
Longbridge Financial, LLC (NMLS# 957935)

Remote Sales and Customer Service Representative

Longbridge Financial, LLC (NMLS# 957935)
51 – 200 Қызметкерлер
Жылжымайтын мүлікҚаржы

Support Longbridge Financial’s reverse mortgage customers by answering inquiries, qualifying leads, and arranging handoffs to the Retail Sales team. The role handles inbound and outbound calls, follow-up appointments, information packets, and CRM records.

Ашу
Teleperformance

German-Speaking Customer Support Representative in Sarajevo or Tuzla

Teleperformance

Support customers in German for Teleperformance in Sarajevo or Tuzla, assisting them by phone, email, and chat. The role is on-site and includes full-time training.

Ашу
CodaMetrix

Senior Director of Account Management

CodaMetrix

Lead enterprise account teams at CodaMetrix, supporting health systems using its AI-powered medical coding platform. Drive retention, account growth, successful go-lives, and customer health.

Ашу