Provider Engagement Account Manager

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. NOTE: Due to travel requirements, for this role, we are seeking candidates who live in Georgia, specifically Cobb, Dekalb, Fulton, or Gwinnett County 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 planTriages provider issues as needed and coordinates response with internal matrix partners.Receive and effectively respond to external provider related issuesManages provider performance for assigned territory through a consultative/account management approachEvaluates provider performance and develops strategic plan to improve performanceDrives provider performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc.Completes special projects as assignedAbility to travel locally 4 days a weekPerforms other duties as assignedComplies with all policies and standardsDirect 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…

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