Provider Relations Account Manager - Travel Required

Centene Corporation; Athens (GA); Híbrido; USD 56.000 - 101.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Descripción de la vacante

Centene Corporation in Georgia seeks a Provider Relations Specialist to maintain partnerships between the health plan and provider networks. You will build client relations to ensure high-quality care for members and drive contract performance through consultative account management.

Responsibilities include traveling across a multi-county territory, educating providers on policies, and improving HEDIS/quality outcomes while managing issues with internal partners.

Formación

• Bachelor’s degree in related field or equivalent experience.
• Two years of managed care, provider relations, quality improvement, claims, contracting utilization management, or clinical operations.
• Project management experience in a medical group, IPA, or health plan setting.
• Proficient in HEDIS/Quality measures; knowledge of Risk Adjustment and VBC preferred.

Responsabilidades

• Serve as primary contact for providers and liaise between providers and the health plan.
• Triages provider issues for resolution with internal partners.
• Educate providers on referrals, claims submission, and related topics.
• Manage network performance for the assigned territory through a consultative approach.
• Travel locally about 4 days a week.

Conocimientos

Provider relations

Account management

Project management

Educación

Bachelor’s degree or equivalent experience

Descripción del empleo

Centene Corporation in Georgia seeks a Provider Relations Specialist to maintain partnerships between the health plan and provider networks. You will build client relations to ensure high-quality care for members and drive contract performance through consultative account management.

Responsibilities include traveling across a multi-county territory, educating providers on policies, and improving HEDIS/quality outcomes while managing issues with internal partners.