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Centene Corporation
Centene Corporation
ApdrošināšanaKonsultācijasVeselības aprūpe
Centene Corporation ir veselības aprūpes un apdrošināšanas uzņēmums, kas koncentrējas uz valsts atbalstītu segumu un kopienu veselību. Tā pakalpojumi ietver Medicaid, Medicare, Health Insurance Marketplace plānus un TRICARE atbalstu militārajām kopienām. Centene apvieno aprūpes nodrošināšanu vietējā līmenī ar partnerību ar bezpeļņas organizācijām, lai apmierinātu to biedru vajadzības, kuriem tā sniedz pakalpojumus. Uzņēmums savā darbībā un kopienu atbalstā ņem vērā arī vides atbildību un ētisku pārvaldību.
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Vakances uzņēmumā

Provider Engagement Account Manager - Wichita, KS (Hybrid)

Build and strengthen Centene’s contracted provider networks in Wichita. Improve provider quality, cost utilization, claims resolution, and contract incentive performance.

USAmerikas Savienotās ValstisKSKanzasa
56 200 $ – 101 000 $ / gads
HibrīdiPilna slodzeJaunākais speciālistsVidējais līmenisNepieciešamā Valoda: angļuKlientu vadītājsPārdošana

Apraksts

  • Maintain relationships between the health plan and contracted provider networks
  • Strengthen provider relationships to support high-quality member care
  • Collaborate with providers to identify network performance opportunities and solutions
  • Manage provider accounts consultatively and oversee issue resolution
  • Improve contract incentive results, quality outcomes, and cost utilization
  • Act as the primary liaison between providers and the health plan
  • Route provider concerns to appropriate internal teams
  • Address issues raised by external providers
  • Investigate, resolve, and communicate provider claims issues and updates
  • Process changes to provider demographic information
  • Train providers on referrals, claims submission, website functions, EDI solicitation, and related processes
  • Conduct provider onboarding sessions and continuing education
  • Create and maintain provider orientation materials
  • Oversee network performance across the assigned territory
  • Assess provider results and create targeted improvement plans
  • Advance performance in Risk/P4Q, HBR, HEDIS/quality, cost, and utilization measures
  • Complete special assignments and other delegated responsibilities
  • Follow applicable policies, procedures, and standards

Prasības

  • Bachelor’s degree in a related discipline or equivalent practical experience
  • At least 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, independent practice association, or health plan environment
  • Working knowledge of HEDIS and quality measures, cost, and utilization
  • Must reside in Wichita, Kansas
  • Availability for local travel four days per week
  • Applicants with arrest or conviction records will be considered as required by the LA County Ordinance and California Fair Chance Act

Priekšrocības

  • Competitive compensation
  • Health insurance coverage
  • 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
  • Equal opportunity and diversity commitment

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