Provider Engagement Account Manager

Centene Corporation

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

Posted 9/23/2026full-timeRemote • South Carolina • United StatesJuniorMid-Level💰 $56,200 - $101,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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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 improvements in cost and utilization.

Highest-signal resume keywords

Provider Relations ManagementHEDIS/Quality Measures ProficiencyManaged Care ExperienceProject Management ExperienceLocal Travel Capability

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quality ImprovementClaims ManagementContracting Utilization ManagementCost Utilization AnalysisProvider Performance EvaluationStrategic Improvement PlanningDemographic Information ManagementIssue ResolutionConsultative Account ManagementProvider Education

Soft Skills

Client RelationsCommunicationProblem-SolvingCollaborationAccountability

Industry Keywords

Managed CareHealth PlanProvider NetworksHome Health OperationsSNF OperationsLTSS OperationsRisk/P4QHBRTravel RequirementsProvider Orientations

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 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 the primary provider contact and liaison with 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
Enter provider-related 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 an assigned territory
Evaluate provider performance and develop strategic improvement plans
Drive improvements 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
Home health, SNF or LTSS operations experience strongly preferred
Candidates must live in South Carolina due to travel requirements
Ability to travel locally 4 days a week

Benefits

Comp & perks

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
Equal opportunity employer committed to diversity