Provider Engagement Account Executive

Centene Corp.; United States; On-site; USD 88,000 - 158,000; Full time

Job summary

Centene Corp. seeks an Provider Engagement Account Executive to develop and maintain strategic partnerships between the health plan and provider networks, advancing value-based care initiatives and improving member outcomes.

You will act as a trusted advisor, delivering data-driven insights, education, and operational support while managing VBP contracts and driving performance improvement across VBPs.

Qualifications

• Bachelor’s degree or equivalent experience; advanced degree preferred.
• Minimum five years in managed care, provider relations, or related fields.
• Experience with value-based care concepts and performance improvement.

Responsibilities

• Develop and maintain strategic partnerships between the health plan and provider networks.
• Serve as VBP SME with guidance on design, reporting, and financial methodologies.
• Deliver training and support to provider orgs on VBP programs and processes.
• Analyze data to identify trends, risks, and improvement opportunities; present insights.

Skills

Provider relationships

Executive communication

Analytical thinking

Contracting/negotiation

Project management

Education

Bachelor’s degree or equivalent experience

Master’s degree preferred in MOH/MHA or MBA

Tools

Excel

Dashboards

Reporting tools

Job description

**Position Purpose:** The Provider Engagement Account Executive will 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:** *Ability to travel several days a week or as required. 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.* Resolves provider issues as needed for resolution to internal partners and creating effeciencies to prevent continued concerns.* 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: $87,700.00 - $157,800.00 per year