Provider Engagement Account Executive

Centene Management Company LLC; Kentucky; Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

competitive pay

health insurance

401K and stock purchase plans

tuition reimbursement

paid time off plus holidays

remote, hybrid, field or office work

Job summary

Centene is seeking a Senior Manager to develop and maintain strategic partnerships between the health plan and contracted provider networks in Kentucky, advancing value-based care initiatives and improving member outcomes. The role requires a bachelor’s degree and 5+ years in managed care or provider relations, with a Master’s degree preferred.

You will serve as the VBP SME, deliver training, analyze data with Excel and dashboards, and support contracting strategy. Travel locally as needed.

Qualifications

• Bachelor’s degree in related field or equivalent experience. Master’s Degree preferred in Public Health (MOH), Health Administration (MHA) or Business Administration (MBA).
• Five or more years of managed care or medical group experience, provider relations, quality improvement, utilization management, or clinical operations.
• Project management experience at a medical group, IPA, or health plan setting.
• Executive level exposure and ability to influence desired outcomes, innovation, performance, member improvements, growth and Provider retention.
• Ability to synthesize complex issues at multiple organizational levels, externally and internally across multi-disciplinary teams.
• Highly proficient in HEDIS/Quality measures, cost and utilization.

Responsibilities

• Develop and maintain strategic partnerships between the health plan and provider networks to advance value-based care.
• Serve as a trusted advisor delivering data-driven insights, operational support, and performance improvement strategies.
• Manage and maintain the VBP contract portfolio, resolve operational issues, and support payment execution.
• Analyze datasets using Excel, dashboards, and reporting tools to identify performance trends, risks, and opportunities.
• Deliver executive-level presentations translating provider performance data into actionable insights.
• Drive VBP success through process improvements and best-practice playbooks.
• Execute provider performance improvement strategies across VBPs (quality, P4P, cost, utilization).
• Build relationships with provider leaders and cross-functional teams; support contracting strategy.
• Review and apply value-based/provider contract language; educate providers on policies and processes.
• Travel locally 4 days a week as required.

Skills

Managed care experience

Provider relations

Quality improvement

Utilization management

Clinical operations

Project management

Executive influence

Data interpretation

Education

Bachelor’s degree in related field

Master’s Degree preferred (MOH/MHA/MBA)

Tools

Excel

Job description

Position Purpose

Develop and maintain strategic partnerships between the health plan and contracted provider networks to advance value-based care initiatives, improve provider performance, and enhance member outcomes. Serve as a trusted advisor to providers and internal stakeholders by delivering data-driven insights, operational support, and performance improvement strategies. Contribute to network management, contracting, and value-based payment (VBP) program success through program administration, relationship management, analytics, education, and process optimization.

Key Details

For this role, we are only considering qualified applicants residing/currently living in Kentucky. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Serve as the primary strategic partner and point of contact for hospital systems, multispecialty groups, and large primary care organizations participating in value-based and risk-based arrangements. Act as the Value-Based Program (VBP) subject matter expert by providing guidance on program design, reporting tools, performance metrics, and financial methodologies.

Deliver training, education, and ongoing support to provider organizations and health plan teammates to ensure proficiency with VBP programs, reporting, and operational processes. Manage and maintain the VBP contract portfolio by resolving operational issues, correcting data discrepancies, and supporting payment execution.

Analyze and interpret complex datasets using Excel, dashboards, and reporting tools to identify performance trends, risks, and improvement opportunities. Develop and deliver executive-level presentations that translate provider performance data into actionable insights and recommendations. Drive VBP success through process improvement initiatives, operational efficiencies, and development of best-practice playbooks.

Execute provider performance improvement strategies across VBPs, including quality, pay-for-performance (P4P), cost, and utilization initiatives, by evaluating performance, developing action plans, and monitoring progress toward established goals.

Build and maintain strong relationships with provider leaders, executive stakeholders, and cross-functional internal teams. Support contracting strategy by providing insights on provider relationships, market dynamics, and organizational considerations that influence negotiations and performance outcomes.

Review, interpret, and apply value-based and provider contract language to support operational execution and issue resolution. Educate providers on policies, procedures, claims submission requirements, referral processes, EDI capabilities, and provider portal tools. Provide leadership, guidance, and mentorship to provider-facing team members and external partners. Resolve provider issues as needed for resolution to internal partners and creating efficiencies to prevent continued concerns.

Ability to travel locally 4 days a week, or as required. Perform other duties as assigned and maintain compliance with organizational policies, standards, and regulatory requirements.

Education & Experience

Bachelor’s degree in related field or equivalent experience. Master’s Degree preferred in Public Health (MOH), Health Administration (MHA) or Business Administration (MBA). Five or more years of managed care or medical group experience, provider relations, quality improvement, utilization management, or clinical operations. Project management experience at a medical group, IPA, or health plan setting. Executive level exposure and ability to influence desired outcomes, innovation, performance, member improvements, growth and Provider retention. Ability to synthesize complex issues at multiple organizational levels, externally and internally across multi-disciplinary teams. Highly proficient in HEDIS/Quality measures, cost and utilization.

Pay Range

Pay Range: $87,700.00 - $157,800.00 per year

Benefits

• competitive pay


• health insurance


• 401K and stock purchase plans


• tuition reimbursement


• paid time off plus holidays


• and a flexible approach to work with remote, hybrid, field or office work schedules


• Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status


• Total compensation may also include additional forms of incentives


• Benefits may be subject to program eligibility

Equal Opportunity

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

About Centene

At Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. Its work with a purpose you can see, backed by a team committed to improving lives well beyond the workday. Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.

Closing

We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.