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Provider Engagement Account Manager
Centene Corporation. Maintain partnerships between the health plan and contracted provider networks .
Posted 9/17/2026full-timeTennessee • 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, 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 RelationsHEDIS/Quality MeasuresManaged Care ExperienceProject ManagementAccountability for Issue Resolution
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 ImprovementClaims ManagementUtilization ManagementContractingData EntryPerformance EvaluationStrategic Improvement PlanningCost Utilization AnalysisProvider EducationNetwork Performance Management
Soft Skills
Client RelationsCommunicationProblem SolvingCollaborationTriage Skills
Industry Keywords
Managed CareHealth PlanProvider NetworksRisk/P4QHBRTennesseeClinical OperationsMedical GroupConsultative Account ManagementEDI Solicitation
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 of provider demographic information changes
- Educate providers on referrals, claims submission, website usage, EDI solicitation, and related topics
- Perform 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 policies and standards
Requirements
What you’ll need- Candidates must live in Tennessee (TN)
- 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
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation
- Equal opportunity employer committed to diversity