Senior Provider Engagement Account Manager

Centene Corporation

. Develop strategic partnerships between the health plan and contracted provider networks .

Posted 9/15/2026full-timeRemote • Washington • United StatesSenior💰 $70,100 - $126,200 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider relations and network management, with a strong focus on performance improvement, quality measures, and effective communication. Proficient in HEDIS and value-based performance tools, ensuring accountability and strategic partnerships within the health plan and provider networks.

Highest-signal resume keywords

Provider Relations ManagementHEDIS/Quality Measures ProficiencyManaged Care ExperienceProject Management ExperienceStrong Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Network Performance ManagementClaims ResolutionQuality ImprovementUtilization ManagementContractingData InterpretationPerformance Improvement InitiativesStrategic Partnership DevelopmentProvider EducationAccount Management

Soft Skills

Strong CommunicationPresentation SkillsCoaching

Tools & Technologies

Value-Based Performance ToolsEDI Solicitation

Industry Keywords

Managed CareMedical GroupProvider NetworksCost UtilizationRisk/P4QHBR AnalysisClinical Operations

About the role

Key responsibilities & impact

Develop strategic partnerships between the health plan and contracted provider networks
Engage providers to align on network performance opportunities and solutions
Manage provider accounts and ensure accountability for issue resolution
Drive performance in contract incentive performance, quality, and cost utilization
Participate in developing network management strategies
Implement initiatives for performance improvement
Serve as primary provider contact and liaison with the health plan
Identify and deliver solutions to provider concerns and issues
Respond to external provider-related issues
Investigate, resolve, and communicate provider claim issues and changes
Educate providers on referrals, claims submission, website usage, EDI solicitation, and related topics
Perform provider orientations and ongoing provider education
Manage network performance for assigned territory through consultative account management
Evaluate provider performance and develop strategic improvement plans
Drive improvement in Risk/P4Q, HBR, HEDIS/quality, cost, and utilization
Present HBR analysis and create reports for Joint Operating Committee meetings
Develop proficiency in value-based performance tools and educate providers on data interpretation
Coach new and less experienced External Representatives
Perform other assigned duties and comply with policies and standards

Requirements

What you’ll need

Candidates must live in Washington state (WA)
Bachelor’s degree in related field or equivalent experience
Three or more 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
Strong communication and presentation skills
Proficient in HEDIS/Quality measures, cost and utilization
Ability to travel locally 4 days a week

Benefits

Comp & perks

Competitive pay
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