LogoFresh Jobs Ahead
Centene Corporation
Centene Corporation
AsigurăriAsistență medicalăConsultanță
Centene Corporation este o companie de servicii medicale și asigurări axată pe acoperirea finanțată de guvern și pe sănătatea comunităților. Serviciile sale includ Medicaid, Medicare, planuri din cadrul pieței asigurărilor de sănătate și sprijin TRICARE pentru comunitățile militare. Centene combină furnizarea localizată de servicii medicale cu parteneriatele cu organizații nonprofit pentru a răspunde nevoilor membrilor pe care îi deservește. Compania integrează, de asemenea, responsabilitatea față de mediu și guvernanța etică în modul său de operare și de sprijinire a comunităților.
LinkedIn
Locurile de muncă ale companiei

Provider Engagement Account Manager - Kansas Remote

Manage Centene’s provider partnerships across Kansas while improving network quality, cost utilization, claims resolution, and performance outcomes.

USStatele Unite ale AmericiiKSKansas
56.200 $ – 101.000 $ / an
RemoteNormă întreagăJuniorNivel mediuLimbă Obligatorie: englezăManager de conturiVânzări

Descriere

  • Manage relationships between the health plan and contracted provider networks
  • Develop client relationships that support high-quality member care
  • Work with providers to identify network performance opportunities and solutions
  • Deliver consultative account management and oversee issue resolution
  • Improve contract incentive performance, quality, and cost utilization
  • Act as the primary provider contact and health-plan liaison
  • Route provider concerns to internal teams for resolution
  • Address issues raised by external providers
  • Investigate, resolve, and communicate provider claim issues and updates
  • Record changes to provider demographic information
  • Educate providers about referrals, claims submission, website functions, EDI solicitation, and related processes
  • Lead provider orientations and continuing education
  • Create and maintain orientation materials
  • Oversee network performance within the assigned territory
  • Assess provider performance and create strategic improvement plans
  • Advance Risk/P4Q, Health Benefit Ratio, HEDIS/quality, cost, and utilization results
  • Complete special projects and other assigned responsibilities
  • Follow applicable policies and standards

Cerințe

  • Bachelor’s degree in a related field or equivalent experience
  • Two years of experience in managed care or 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
  • Preferred knowledge of Kansas HCBS and LTSS waiver programs, including eligibility, service delivery, and regulatory requirements
  • Residence in Kansas City, Kansas is required
  • Willingness to travel locally four days per week

Beneficii

  • 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
  • Equal opportunity and diversity commitment

Locuri de muncă similare

EY

AI Software Engineer, Financial Advisory

EY
Sponsor pentru viza H1BAsistență medicalăJuridicMarketing
AEEmiratele Arabe UniteRemoteNormă întreagăNivel mediuSeniorLimbă Obligatorie: englezăInginer full-stackInginer software
AWSAzureCloudGoogle Cloud PlatformPythonPyTorchTensorFlow

Build and deploy GenAI, LLM, and MLOps solutions for EY financial advisory clients across the Middle East and North Africa. Contribute to AI strategy, production delivery, and business development.

Deschide
Maxibook OÜ

Scientific Language and AI Adaptation Contributor

Maxibook OÜ
EducațieInteligență artificialăSaaS
RemoteContractNivel mediuSeniorLimbă Obligatorie: arabăLimbă Obligatorie: englezăLimbă Obligatorie: japonezăLimbă Obligatorie: coreeanăInteligență artificială

Help Maxibook, an AI education startup, adapt English scientific content for Korean, Japanese, or Arabic audiences. Assess AI-generated material for accurate concepts, natural language, and academic credibility.

Deschide