Remote Value-Based Care Partnerships Executive

WellCare of Kentucky; Illinois; On-site; USD 88,000 - 158,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work schedules (remote,hybrid

Field or office work schedules

Job summary

Centene is seeking a Provider Engagement Account Executive to build partnerships with hospital systems, groups, and networks driving value-based care initiatives. You will analyze performance, deliver recommendations, and manage VBP programs across multiple teams.

You will lead education efforts, support contract execution, and develop actionable insights from complex data to improve member outcomes and provider performance.

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, provider relations, quality improvement, utilization management, or clinical operations.

Responsibilities

• 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.

Skills

Executive exposure

HEDIS/Quality measures

Data-driven decision making

Education

Bachelor’s degree or equivalent experience

Master’s degree preferred in Public Health or MBA

Job description

Centene is seeking a Provider Engagement Account Executive to build partnerships with hospital systems, groups, and networks driving value-based care initiatives. You will analyze performance, deliver recommendations, and manage VBP programs across multiple teams.

You will lead education efforts, support contract execution, and develop actionable insights from complex data to improve member outcomes and provider performance.