Provider Engagement Account Manager

Centene Corporation

. Maintain partnerships between the health plan and contracted provider networks .

Posted 10/7/2026full-timeRemote • Texas • United StatesJuniorMid-Level💰 $56,200 - $101,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in provider relations, quality improvement, and managed care operations, with a strong focus on HEDIS/Quality measures and performance management. Capable of building client relationships and driving optimal network performance through effective communication and issue resolution.

Highest-signal resume keywords

Provider Relations ManagementHEDIS/Quality Measures ProficiencyManaged Care ExperienceClaims Issue ResolutionContract Performance Improvement

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Quality ImprovementUtilization ManagementClaims ManagementContractingProvider EducationPerformance EvaluationDemographic Data ManagementProject ManagementRisk/P4Q ImprovementCost Utilization Analysis

Soft Skills

Client Relationship BuildingConsultative Account ManagementEffective CommunicationProblem SolvingTeam Collaboration

Industry Keywords

Managed CareHealth PlanProvider NetworkMedical GroupIPAHEDISQuality MeasuresCost UtilizationProvider OrientationEDI Solicitation

About the role

Key responsibilities & impact

Maintain partnerships between the health plan and contracted provider networks
Build client relations to ensure delivery of the highest level of care to members
Engage with providers to align on network performance opportunities and solutions
Provide consultative account management and accountability for issue resolution
Drive optimal performance in contract incentive performance, quality, and cost utilization
Serve as primary contact for providers and liaison between providers and the health plan
Triage provider issues for resolution with internal partners
Respond to external provider-related issues
Investigate, resolve, and communicate provider claim issues and changes
Enter provider-related demographic information changes
Educate providers on referrals, claims submission, website usage, EDI solicitation, and related topics
Perform provider orientations and ongoing provider education
Write and update orientation materials
Manage network performance for assigned territory
Evaluate provider performance and develop strategic improvement plans
Drive provider performance improvement in Risk/P4Q, HBR, HEDIS/quality, cost, and utilization
Complete special projects and other assigned duties
Comply with all policies and standards

Requirements

What you’ll need

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Bachelor’s degree in related field or equivalent experience
Two years of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management, or clinical operations or project management experience at a medical group, IPA, or health plan setting
Proficient in HEDIS/Quality measures, cost and utilization
Ability to travel locally 4 days a week

Benefits

Comp & perks

Competitive pay
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation