Provider Engagement Account Manager

Centene Corporation

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

Posted 10/9/2026full-timeWest Palm Beach • Florida • 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 the healthcare sector. Proficient in HEDIS measures and consultative account management to enhance provider engagement and performance.

Highest-signal resume keywords

Provider RelationsHEDIS/Quality MeasuresManaged Care ExperienceProject ManagementNetwork Performance Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quality ImprovementClaims ManagementUtilization ManagementContractingDemographic Information ManagementPerformance ImprovementConsultative Account ManagementIssue ResolutionProvider EducationStrategic Improvement Plans

Soft Skills

Client RelationsCommunicationProblem SolvingCollaborationTriage

Industry Keywords

Managed CareHealth PlanProvider NetworksCost UtilizationRisk/P4QHBRClinical OperationsProvider OrientationsFlorida CountiesLocal Travel

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 to align 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 contact for providers and liaison between providers and the health plan
Triage provider issues to 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 education, including writing and updating orientation materials
Manage network performance for assigned territory through a consultative/account management approach
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

Candidates must live in Florida within the following counties: Indian River, Martin, Cheechobee, Palm Beach and St. Lucie
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
stock purchase plans
tuition reimbursement
paid time off plus holidays
a flexible approach to work with remote, hybrid, field or office work schedules
additional forms of incentives may be included in total compensation