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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.
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Locurile de muncă ale companiei

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.

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

Descriere

  • 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

Cerințe

  • 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

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

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