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Provider Engagement Account Manager
Centene Corporation. Maintain partnerships between the health plan and contracted provider networks serving communities .
Posted 9/17/2026full-timeRemote • Tennessee • 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 HEDIS measures and performance management. Proven ability to build partnerships, educate providers, and drive optimal network performance.
Highest-signal resume keywords
Provider Relations ManagementHEDIS/Quality Measures ProficiencyManaged Care ExperienceProject Management ExperienceConsultative Account 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 ImprovementClaims ManagementUtilization ManagementContractingData EntryPerformance EvaluationStrategic PlanningIssue ResolutionProvider EducationDemographic Information Management
Soft Skills
Client RelationsCommunicationProblem SolvingCollaborationAccountability
Industry Keywords
Managed CareHealth PlanProvider NetworksRisk/P4QHealth Benefit Ratio (HBR)HEDISConsultative ApproachLocal TravelTennessee (TN) ResidencyMedical Group Experience
About the role
Key responsibilities & impact- Maintain partnerships between the health plan and contracted provider networks serving communities
- Build client relations to ensure delivery of the highest level of care to members
- Engage with providers to align on network performance opportunities and solutions
- Provide consultative account management and accountability for issue resolution
- Drive optimal 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 for resolution to internal partners
- Respond to external provider-related issues
- Investigate, resolve, and communicate provider claim issues and changes
- Initiate data entry of provider-related demographic information changes
- Educate providers on policies and procedures related to referrals, claims submission, website usage, EDI solicitation, and related topics
- Perform provider orientations and ongoing provider 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 plans to improve performance
- Drive provider performance improvement in Risk/P4Q, Health Benefit Ratio (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 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- 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