Remote/Field Provider Engagement Manager

centene; Town of Texas (WI); Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off + holidays

Flexible work model

Job summary

Centene seeks a field-based Provider Relations Manager covering Lubbock and Amarillo Counties. You will maintain partnerships between the health plan and provider networks, triage issues, educate providers on policies, and drive performance in quality, cost and utilization.

Requirements include a Bachelor's degree or equivalent experience, two years in managed care or provider relations, and willingness to travel up to four days a week. Competitive pay with comprehensive benefits.

Qualifications

• Bachelor's degree or equivalent experience.
• Two years of managed care or provider relations experience.
• Proficient in HEDIS/Quality measures and cost/utilization concepts.

Responsibilities

• Serve as primary contact for providers and liaise between providers and the health plan.
• Triages provider issues and coordinates resolution with internal partners.
• Educate providers on policies, referrals, claims, and EDI processes.
• Manage network performance and develop plans to improve quality and cost/utilization metrics.

Skills

Provider relations

Account management

HEDIS/Quality measures

Education

Bachelor's degree or equivalent experience

Job description

Centene seeks a field-based Provider Relations Manager covering Lubbock and Amarillo Counties. You will maintain partnerships between the health plan and provider networks, triage issues, educate providers on policies, and drive performance in quality, cost and utilization.

Requirements include a Bachelor's degree or equivalent experience, two years in managed care or provider relations, and willingness to travel up to four days a week. Competitive pay with comprehensive benefits.