? (Apply in 3 Minutes) Provider Engagement Account Manager Position Available In New York, New York

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.

Position Purpose:

Maintain partnershipsbetween the health plan and the contracted provider networksserving our communities. Build client relations to ensure deliveryof the highest level of care to our members. Engage with providersto align on network performance opportunities and solutions, andconsultative account management and accountability for issueresolution. Drive optimal performance in contract incentiveperformance, quality, and cost utilization.

• Conducts regularin-person visits with physicians to provide real-time support,discuss performance metrics, and identify opportunities forimprovement in patient care and clinical practices
• Focuses onvalue-based care model initiatives, collaborating with physiciansto identify and align to performance-based agreements thatincentivize better patient outcomes, cost-efficiency, and qualitycare
• Uses data analytics to track and monitor providerperformance, offering actionable feedback to help physiciansoptimize care delivery and meet key performance targets
• Triagesprovider issues as needed for resolution to internal partners
• Receive and effectively respond to external provider related issues
• Investigate, resolve and communicate provider claim issues andchanges
• Initiate data entry of provider-related demographicinformation changes
• Educate providers regarding policies andprocedures related to referrals and claims submission, web siteusage, EDI solicitation and related topics
• Perform providerorientations and ongoing provider education, including writing andupdating orientation materials
• Manages Network performance forassigned territory through a consultative/account managementapproach
• Evaluates provider performance and develops strategicplan to improve performance
• Drives provider performanceimprovement in the following areas: Risk/P4Q, Health Benefit Ratio(HBR), HEDIS/quality, cost and utilization, etc.
• Completesspecial projects as assigned
• Ability to travel locally 4 days aweek
• Performs other duties as assigned
• Complies with allpolicies and standards

Education/Experience:

Bachelor’s degree inrelated field or equivalent experience. Two years of managed careor medical group experience, provider relations, qualityimprovement, claims, contracting utilization management, orclinical operations. Project management experience at a medicalgroup, IPA, or health plan setting. Proficient in HEDIS/Qualitymeasures, cost and utilization.

Pay Range:

$55,100.00

• $99,000.

00per year Centene offers a comprehensive benefits package including:competitive pay, health insurance, 401K and stock purchase plans,tuition reimbursement, paid time off plus holidays, and a flexibleapproach to work with remote, hybrid, field or office workschedules. Actual pay will be adjusted based on an individual’sskills, experience, education, and other job-related factorspermitted by law, including full-time or part-time status. Totalcompensation may also include additional forms of incentives.

Benefits may be subject to program eligibility. Centene is an equalopportunity employer that is committed to diversity, and values theways in which we are different. All qualified applicants willreceive consideration for employment without regard to race, color,religion, sex, sexual orientation, gender identity, nationalorigin, disability, veteran status, or other characteristicprotected by applicable law. Qualified applicants with arrest orconviction records will be considered in accordance with the LACounty Ordinance and the California Fair Chance Act