Talent.com
Provider Engagement Account Manager
Provider Engagement Account ManagerOklahoma Complete Health • Tulsa, OK, US
Provider Engagement Account Manager

Provider Engagement Account Manager

Oklahoma Complete Health • Tulsa, OK, US
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
  • [job_card.part_time]
[job_card.job_description]

Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

  • For this role we are seeking candidates who live in Oklahoma

Position Purpose : Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery of the highest level of care to our members. Engage with providers to align on network performance opportunities and solutions, and consultative account management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization.

  • Serve as primary contact for providers and act as a liaison between the providers and the health plan
  • Triages provider issues as needed for resolution to internal partners
  • Receive and effectively respond to external provider related issues
  • Investigate, resolve and communicate provider claim issues and changes
  • Initiate data entry of provider-related demographic information changes
  • Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics
  • Perform provider orientations and ongoing provider education, including writing and updating orientation materials
  • Manages Network performance for assigned territory through a consultative / account management approach
  • Evaluates provider performance and develops strategic plan to improve performance
  • Drives provider performance improvement in the following areas : Risk / P4Q, Health Benefit Ratio (HBR), HEDIS / quality, cost and utilization, etc.
  • Completes special projects as assigned
  • Ability to travel locally 4 days a week
  • Performs other duties as assigned
  • Complies with all policies and standards
  • Direct Provider Engagement : Conducts regular in-person visits with physicians to provide real-time support, discuss performance metrics, and identify opportunities for improvement in patient care and clinical practices.
  • Value-Based Care Model : Focuses on value-based care model initiatives, collaborating with physicians to identify and align to performance-based agreements that incentivize better patient outcomes, cost-efficiency, and quality care.
  • Performance Management : Uses data analytics to track and monitor provider performance, offering actionable feedback to help physicians optimize care delivery and meet key performance targets.
  • Education / Experience : Bachelor’s degree in related field or equivalent experience.

    Two years of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management, or clinical operations.

    Project management experience at a medical group, IPA, or health plan setting.

    Proficient in HEDIS / Quality measures, cost and utilization.Pay Range : $55,100.00 - $99,000.00 per 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 flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

    Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

    [job_alerts.create_a_job]

    Provider Engagement Account Manager • Tulsa, OK, US

    [internal_linking.related_jobs]
    Senior VBC Provider Engagement & Contracting Strategy Consultant

    Senior VBC Provider Engagement & Contracting Strategy Consultant

    Health Care Service Corporation • Tulsa, OK, US
    [job_card.full_time]
    At HCSC, our employees are the cornerstone of our business and the foundation to our success.We empower employees with curated development plans that foster growth and promote rewarding, fulfilling...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Technical Account Manager

    Senior Technical Account Manager

    Genesys • Tulsa, OK, US
    [job_card.full_time]
    Senior Technical Account Manager.Genesys empowers organizations of all sizes to improve loyalty and business outcomes by creating the best experiences for their customers and employees.Through Gene...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Affiliate Marketing Manager

    Affiliate Marketing Manager

    DeleteMe • Tulsa, OK, US
    [job_card.full_time]
    DeleteMe is the leader in proactive privacy protection.We help Individuals, Families, Businesses and Security teams reduce their human attack surface by continuously monitoring and removing exposed...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Account Manager, Commercial Lines

    Account Manager, Commercial Lines

    Hub International Insurance • Tulsa, Oklahoma, USA
    [job_card.full_time]
    The Commercial Lines Account Manager works collaboratively with the Risk Consultants and Account Executives managing a book of business. Coordinates and provides day-to-day service for property / casu...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    US IBC Strategic Channel Account Leader

    US IBC Strategic Channel Account Leader

    ABB • Tulsa, OK, US
    [job_card.full_time]
    At ABB, we help industries outrun - leaner and cleaner.Here, progress is an expectation - for you, your team, and the world. As a global market leader, we'll give you what you need to make it happen...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Account Director- Strategic CRO Accounts

    Account Director- Strategic CRO Accounts

    H1 • Tulsa, OK, US
    [job_card.full_time]
    Account Director- Strategic CRO Accounts.At H1, we believe access to the best healthcare information is a basic human right. Our mission is to provide a platform that can optimally inform every doct...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Cold Email Inbox Manager (Associate of Investor Relations)

    Cold Email Inbox Manager (Associate of Investor Relations)

    Lago • Tulsa, OK, US
    [job_card.full_time]
    Cold Email Inbox Manager (Associate of Investor Relations).Role : Cold Email Inbox Manager (Associate of Investor Relations) Hours : U. Based, 9AM5PM EST required Salary : $800 - $1,000 USD per month |...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Regional Account Manager / Healthcare

    Regional Account Manager / Healthcare

    BrightSpring Health Services • Tulsa, OK, United States
    [job_card.full_time]
    Regional Account Manager / Healthcare.US-OK-OKLAHOMA CITY | US-OK-TULSA | US-AR-BENTONVILLE.Using a balance of account management and direct telephone outreach, the primary responsibility of the.In...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Account Manager - Commercial Lines

    Senior Account Manager - Commercial Lines

    Insurance Office of America • Tulsa, OK, US
    [job_card.full_time]
    Title : Senior Account Manager - Commercial Lines.Fully Remote | Book Focus : Real Estate.Please note : If this position is posted as either fully remote and / or hybrid, in accordance with company poli...[show_more]
    [last_updated.last_updated_30]
    Functional Wellness Provider

    Functional Wellness Provider

    JW Holland Wellness • Bixby, OK, USA
    [job_card.part_time]
    [filters_job_card.quick_apply]
    About JW Holland Wellness & Aesthetics.At JW Holland Wellness & Aesthetics, we're redefining what it means to feel your best. We don't just treat symptoms; we uncover root causes, restore ba...[show_more]
    [last_updated.last_updated_variable_days]
    Supply Account Manager

    Supply Account Manager

    Appodeal • Tulsa, OK, US
    [job_card.full_time]
    Appodeal is a dynamic US-based product company with a truly global presence.We have offices in Warsaw, Barcelona, and Virginia along with remote team members located around the world.Our company th...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Account Manager

    Senior Account Manager

    Marqeta • Tulsa, OK, US
    [job_card.full_time]
    Marqeta is on a mission to change the way money moves.We're one of the earliest enablers of embedded finance, a market opportunity sized up in the trillions. Our card-issuing platform provides unpre...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Client Account Manager

    Client Account Manager

    Centre Technologies • Tulsa, OK, US
    [job_card.full_time]
    [filters_job_card.quick_apply]
    Position Summary Centre is seeking a client-focused individual to serve as a Client Account Manager, responsible for strengthening and expanding relationships with existing clients acros...[show_more]
    [last_updated.last_updated_30]
    Channel Account Manager, Strategic VAR's- Remote- Utah, Colorado, Arizona, New Mexico based opportunity

    Channel Account Manager, Strategic VAR's- Remote- Utah, Colorado, Arizona, New Mexico based opportunity

    Mitel • Tulsa, OK, US
    [filters.remote]
    [job_card.full_time] +1
    At Mitel, you will have the opportunity to help businesses connect, collaborate and provide better experiences for our customers. You will deliver valuable contributions in creating business success...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Account Manager, Interventional Technologies (Charlotte, NC)

    Account Manager, Interventional Technologies (Charlotte, NC)

    Haemonetics • Tulsa, OK, US
    [job_card.full_time]
    We are constantly looking to add to our core talent.If you are seeking a career that is challenging and rewarding, a work environment that is diverse and dynamic, look no furtherHaemonetics is your...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Account Manager Promotional Products Remote

    Account Manager Promotional Products Remote

    Logotech • Tulsa, OK, US
    [filters.remote]
    [job_card.full_time]
    Apply Now! We Are Growing, And We Need You!.Logotech is a leader in supplying innovative promotional products for a large and growing client portfolio. We are expanding and are looking for talented ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Commercial Lines Account Manager

    Commercial Lines Account Manager

    Gpac • Tulsa, Oklahoma, United States
    [job_card.full_time]
    [filters_job_card.quick_apply]
    Position : Commercial Insurance Account Manager .Working for an Insurance Agency.Accurately input policy updates and account information. Communicate with client, producer, and carrier underwrit...[show_more]
    [last_updated.last_updated_variable_days]
    Territory Account Manager- Signals Software Solutions, NA-West Region

    Territory Account Manager- Signals Software Solutions, NA-West Region

    Revvity • Tulsa, OK, US
    [job_card.full_time]
    Territory Account Manager- Signals Software Solutions, NA-West Region.The Account Executive position will be responsible for identifying new opportunities and selling Signals Software Solutions to ...[show_more]
    [last_updated.last_updated_30] • [promoted]