Provider Engagement Account Executive

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🔥 0 minutes ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

💵 $87.7k - $157.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧑‍💼 Account Executive

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Develop and maintain strategic partnerships between the health plan and contracted provider networks • Advance value-based care initiatives, improve provider performance, and enhance member outcomes • Serve as a trusted advisor to providers and internal stakeholders through data-driven insights, operational support, and performance improvement strategies • Serve as primary strategic partner and point of contact for hospital systems, multispecialty groups, and large primary care organizations • Provide guidance on value-based program design, reporting tools, performance metrics, and financial methodologies • Deliver training, education, and ongoing support on value-based programs, reporting, and operational processes • Manage and maintain the value-based payment contract portfolio, resolve operational issues, correct data discrepancies, and support payment execution • Analyze complex datasets using Excel, dashboards, and reporting tools • Develop executive-level presentations translating provider performance data into actionable insights and recommendations • Drive process improvement initiatives, operational efficiencies, and best-practice playbooks • Execute provider performance improvement strategies across quality, pay-for-performance, cost, and utilization initiatives • Build and maintain relationships with provider leaders, executive stakeholders, and cross-functional internal teams • Support contracting strategy with insights on provider relationships, market dynamics, and organizational considerations • Review, interpret, and apply value-based and provider contract language • 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 • Resolve provider issues and create efficiencies to prevent recurring concerns • Perform other duties as assigned

🎯 Requirements

• Qualified applicants must reside/currently live in Kentucky • Must be authorized to work in the U.S. without employment-based visa sponsorship now or in the future • Bachelor’s degree in related field or equivalent experience • Five or more years of managed care or medical group experience, provider relations, quality improvement, utilization management, or clinical operations • Project management experience at a medical group, IPA, or health plan setting • Executive-level exposure and ability to influence desired outcomes, innovation, performance, member improvements, growth, and provider retention • Ability to synthesize complex issues at multiple organizational levels across multidisciplinary teams • Highly proficient in HEDIS/Quality measures, cost, and utilization • Ability to travel locally 4 days a week, or as required • Must maintain compliance with organizational policies, standards, and regulatory requirements

🏖️ Benefits

• Competitive pay • Health insurance • 401K • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity