Field-Based Provider Engagement Manager

Centene Management Company LLC; New Jersey; Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off

Job summary

Centene Management Company LLC in New Jersey is seeking a field-based Provider Relations professional who will maintain partnerships between the health plan and contracted provider networks to deliver high‑quality care. The role emphasizes consultative account management and issue resolution to drive performance.

The ideal candidate has a bachelor’s degree and at least two years in managed care or provider relations, with experience in HEDIS/quality measures.

Qualifications

• Bachelor's degree in a related field or equivalent experience.
• Minimum of two years in managed care, provider relations, or related operations.
• Experience with HEDIS/quality measures is preferred.

Responsibilities

• Serve as primary contact for providers and liaise between providers and the health plan.
• Triages provider issues for resolution with internal partners.
• Respond to external provider-related issues and inquiries.
• Investigate and communicate provider claim issues and changes.
• Educate providers on referrals, claims submission, and related tools.
• Travel locally up to four days per week to support network performance.
• Manage network performance for the assigned territory using a consultative approach.
• Evaluate provider performance and develop plans to improve outcomes.

Skills

Provider relations

Account management

HEDIS measures

Data analysis

Communication

Education

Bachelor's degree

Job description

Centene Management Company LLC in New Jersey is seeking a field-based Provider Relations professional who will maintain partnerships between the health plan and contracted provider networks to deliver high‑quality care. The role emphasizes consultative account management and issue resolution to drive performance.

The ideal candidate has a bachelor’s degree and at least two years in managed care or provider relations, with experience in HEDIS/quality measures.