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Provider Engagement Account Manager
Centene Corporation. Maintain partnerships between the health plan and contracted provider networks .
Posted 9/16/2026full-timeRemote • Arizona • United StatesJuniorMid-Level💰 $56,200 - $101,000 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in provider relations, network performance management, and quality improvement within the healthcare sector. Proficient in HEDIS measures and claims resolution, with strong project management capabilities.
Highest-signal resume keywords
Provider RelationsHEDIS/Quality MeasuresProject ManagementClaims ResolutionNetwork Performance Management
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Quality ImprovementUtilization ManagementClaims SubmissionContractingProvider EducationData AnalysisDemographic Information ManagementPerformance EvaluationStrategic Improvement PlanningRisk Management
Soft Skills
Client RelationsProblem SolvingCommunicationCollaborationTriage
Industry Keywords
Managed CareMedical GroupHealth PlanProvider NetworksCost ManagementUtilizationP4QHBRLocal TravelOrientation Materials
About the role
Key responsibilities & impact- Maintain partnerships between the health plan and contracted provider networks
- Build client relations to ensure the highest level of care for members
- Engage providers on network performance opportunities and solutions
- Serve as primary provider contact and liaison with the health plan
- Triage and resolve provider issues with internal partners
- 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, HBR, HEDIS/quality, cost, and utilization
- Complete special projects and other assigned duties
- Comply with all policies and standards
Requirements
What you’ll need- Candidate must live in Mohave 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- 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