Provider Engagement Account Manager

Centene Corporation

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

Posted 10/1/2026full-timeRemote • Kansas • United StatesJuniorMid-Level💰 $56,200 - $101,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider relations, network performance management, and quality improvement within managed care settings. Proficient in HEDIS measures and familiar with Kansas HCBS and LTSS waiver programs, ensuring compliance and effective communication with providers.

Highest-signal resume keywords

Provider Relations ManagementHEDIS/Quality Measures ProficiencyManaged Care ExperienceProject Management ExperienceKansas HCBS and LTSS Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quality ImprovementClaims ManagementContracting Utilization ManagementNetwork Performance EvaluationProvider EducationIssue ResolutionData EntryStrategic Improvement PlanningCost Utilization AnalysisRegulatory Compliance

Soft Skills

Client RelationsCommunicationProblem-SolvingCollaborationAccountability

Industry Keywords

Managed CareHealth PlanProvider NetworksKansas CityLocal TravelService DeliveryEligibilityHealth Benefit RatioP4QProvider Orientation

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
Provide consultative account management and accountability for issue resolution
Drive performance in contract incentive performance, quality, and cost utilization
Serve as primary provider contact and liaison with 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
Enter provider demographic information changes
Educate providers on referrals, claims submission, website usage, EDI solicitation, and related topics
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, Health Benefit Ratio, HEDIS/quality, cost, and utilization
Complete special projects and other assigned duties
Comply with policies and standards

Requirements

What you’ll need

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
Strong understanding of Kansas HCBS and LTSS waiver programs, including eligibility, service delivery, and regulatory requirements, preferred
Candidates must live in Kansas City, Kansas
Ability to travel locally 4 days a week

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
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
Equal opportunity and diversity commitment