? 15h Left: Provider Engagement Account Manager Position Available In Jefferson, Louisiana

Job Description:

You could be the one who changes everything for our 28 millionmembers. Centene is transforming the health of our communities, oneperson at a time. As a diversified, national organization, you’llhave access to competitive benefits including a fresh perspectiveon workplace flexibility.

NOTE:

For this role we are seekingcandidates who live in

Louisiana Position Purpose:

Maintainpartnerships between the health plan and the contracted providernetworks serving our communities. Build client relations to ensuredelivery of the highest level of care to our members. Engage withproviders to align on network performance opportunities andsolutions, and consultative account management and accountabilityfor issue resolution. Drive optimal performance in contractincentive performance, quality, and cost utilization.

• Serve asprimary contact for providers and act as a liaison between theproviders and the health plan
• Triages provider issues as neededfor resolution to internal partners
• Receive and effectivelyrespond to external provider related issues
• Investigate, resolveand communicate provider claim issues and changes
• Initiate dataentry of provider-related demographic information changes
• Educateproviders regarding policies and procedures related to referralsand claims submission, web site usage, EDI solicitation and relatedtopics
• Perform provider orientations and ongoing providereducation, including writing and updating orientation materials
• Manages Network performance for assigned territory through aconsultative/account management approach
• Evaluates providerperformance and develops strategic plan to improve performance
• Drives provider performance improvement in the following areas:

Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost andutilization, etc.

• Completes special projects as assigned
• Ability to travel locally 4 days a week
• Performs other duties asassigned
• Complies with all policies and standards

Education/Experience:

Bachelor’s degree in related field orequivalent experience. Two years of managed care or medical groupexperience, provider relations, quality improvement, claims,contracting utilization management, or clinical operations. Projectmanagement experience at a medical group, IPA, or health plansetting. Proficient in HEDIS/Quality measures, cost andutilization.

Pay Range:

$55,100.00

• $99,000.

00 per year Centeneoffers a comprehensive benefits package including: competitive pay,health insurance, 401K and stock purchase plans, tuitionreimbursement, paid time off plus holidays, and a flexible approachto work with remote, hybrid, field or office work schedules. Actualpay will be adjusted based on an individual’s skills, experience,education, and other job-related factors permitted by law. Totalcompensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed todiversity, and values the ways in which we are different. Allqualified applicants will receive consideration for employmentwithout regard to race, color, religion, sex, sexual orientation,gender identity, national origin, disability, veteran status, orother characteristic protected by applicable law. Qualifiedapplicants with arrest or conviction records will be considered inaccordance with the LA County Ordinance and the California FairChance Act