FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Provider Engagement Account Manager
Centene Corporation. Maintain partnerships between the health plan and contracted provider networks .
Posted 11/12/2026full-timeMacon • Georgia • 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 managing provider relations and network performance, with a strong focus on quality improvement and claims resolution. Proficient in HEDIS measures and capable of driving strategic initiatives to enhance care delivery and cost utilization.
Highest-signal resume keywords
Provider Relations ManagementHEDIS/Quality Measures ProficiencyProject Management ExperienceManaged Care ExperienceQuality Improvement
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ResolutionContract ManagementUtilization ManagementQuality ImprovementProvider Performance EvaluationDemographic Information ManagementNetwork Performance ManagementStrategic Improvement PlanningConsultative Account ManagementIssue Resolution
Soft Skills
Client RelationsCommunicationProblem-SolvingEducation and TrainingCollaboration
Industry Keywords
Managed CareMedical GroupProvider NetworksCost UtilizationRisk/P4QHBRClinical OperationsEDI SolicitationProvider OrientationHealth Plan
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 relationships 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
- 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
- Perform provider orientations and ongoing education
- Write and update orientation materials
- Manage network performance for 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- 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
- Live within 30 minutes of Macon, GA
- Ability to travel up to 2 hours away
- 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
- Additional forms of incentives may be included in total compensation