? Only 24h Left! Provider Engagement Account Manager
Company: Louisiana Healthcare Connections
Location: Baton Rouge
Posted on: July 1, 2025
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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: For this role we are seeking
candidates who live in Louisiana 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
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. Total
compensation may also include additional forms of incentives.
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
Keywords: Louisiana Healthcare Connections, Baton Rouge , ? Only 24h Left! Provider Engagement Account Manager, Customer Service & Call Center , Baton Rouge, Louisiana
