Provider Engagement Account Manager

Centene Corporation

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

Posted 9/17/2026full-timeRemote • Florida • 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 performance management and issue resolution. Proficient in HEDIS/Quality measures and capable of driving strategic improvement plans within healthcare networks.

Highest-signal resume keywords

Provider Relations ManagementHEDIS/Quality Measures ProficiencyProject Management ExperienceManaged Care ExperienceStrategic Improvement Planning

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data EntryClaims ResolutionQuality ImprovementUtilization ManagementContractingPerformance EvaluationIssue ResolutionProvider EducationNetwork Performance ManagementConsultative Account Management

Soft Skills

Client RelationsCommunicationProblem-SolvingCollaborationAccountability

Industry Keywords

Managed CareProvider NetworksHealthcareCost UtilizationRisk/P4QHBRClinical OperationsMedical GroupIPAFlorida

About the role

Key responsibilities & impact

Maintain partnerships between the health plan and contracted provider networks
Build client relations to support the highest level of care for members
Engage providers on network performance opportunities and solutions
Manage consultative account management and accountability for issue resolution
Drive performance in contract incentive performance, quality, and cost utilization
Serve as primary contact and liaison between providers and the health plan
Triage provider issues to internal partners for resolution
Respond to external provider-related issues
Investigate, resolve, and communicate provider claim issues and changes
Initiate data entry for provider demographic information changes
Educate providers on referrals, claims submission, website usage, and EDI solicitation
Conduct provider orientations and ongoing education; write and update orientation materials
Manage network performance for the assigned territory
Evaluate provider performance and develop strategic improvement plans
Drive 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

Candidates must live in Florida within Miami Dade County
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
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

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
Competitive pay
Additional forms of incentives may be included in total compensation