Provider Account Manager
Location: Atlanta, GA
Job Type: Direct Placement
Company: ARC Group
Category: Administration
Job Description Apply Now
Centene, a leading diversified national health organization, is seeking a dedicated Provider Account Manager to join our growing team in Georgia. This full-time opportunity is designed for professionals passionate about fostering strong relationships with healthcare providers and optimizing network performance. As a Provider Account Manager, you will play an integral role in supporting our mission to transform the health of our communities by ensuring high-quality care and driving value-based initiatives.
In this position, you will serve as the primary point of contact for contracted provider networks, acting as a bridge between healthcare providers and the health plan. Your consultative approach will help address provider concerns, align on performance opportunities, and develop solutions that enhance patient outcomes, cost-efficiency, and care quality. The Provider Account Manager position is ideal for individuals experienced in managed care, account management, and provider relations who thrive in a dynamic and collaborative environment.
Centene’s commitment to flexible workplace solutions means you will benefit from competitive compensation, a comprehensive benefits package, and the chance to make a meaningful impact. If you are motivated by the prospect of working in Georgia’s vibrant healthcare landscape, we invite you to apply today and be a key contributor to our member-centric mission.
Provider Account Manager - Summary- Serve as the primary liaison between the health plan and contracted provider networks.
- Focus on provider engagement, network performance, and value-based care initiatives.
- Drive performance improvement through data analytics and consultative account management.
- Facilitate optimal care delivery and cost management for members in Georgia.
- Establish and maintain collaborative relationships with healthcare providers to promote alignment with health plan objectives.
- Conduct regular in-person visits with providers across assigned territories, offering real-time support and performance feedback.
- Analyze provider performance using data-driven metrics, including HEDIS/quality measures, Health Benefit Ratio (HBR), and cost/utilization analytics.
- Develop and implement strategic plans to improve provider performance in areas such as risk, quality, and value-based contract incentives.
- Address provider issues promptly and coordinate responses with internal teams to ensure satisfactory resolution.
- Support and advise providers on value-based care models, guiding alignment with performance-based agreements that incentivize quality and efficiency.
- Manage special projects and complete assigned duties to support network and organizational goals.
- Ensure compliance with all company policies, standards, and applicable regulations.
- Travel locally as required to maintain active engagement with provider networks in the Georgia market.
- Competitive base salary, commensurate with experience and qualifications.
- Comprehensive health insurance coverage, including medical, dental, and vision plans.
- 401(k) retirement plan with company match and stock purchase plans.
- Tuition reimbursement and opportunities for continued professional development.
- Paid time off (PTO), holidays, and flexible work options including remote, hybrid, field, or office-based arrangements.
- Eligibility for additional performance-based incentives, subject to company policy.
- Bachelor’s degree in a related field or equivalent professional experience.
- At least two years of experience in provider engagement account management within a managed care, health plan, or medical group setting.
- Proficiency in HEDIS/Quality measures, cost/utilization metrics, and managed care contract management.
- Experience with data analytics for performance tracking and improvement.
- Strong communication, relationship-building, and consultative skills.
- Project management experience is highly preferred.
- Ability to travel locally up to four days per week to maintain provider engagement.
- Demonstrates a passion for healthcare transformation and improving community health outcomes.
- Excels in a fast-paced, dynamic environment that values teamwork and innovation.
- Brings strong analytical skills and attention to detail.
- Has a consultative approach to provider engagement and account management.
- Values diversity and inclusion, and is committed to upholding Centene’s mission and values.
- Resides in or is able to travel throughout Georgia, particularly within Cobb, Dekalb, Fulton, or Gwinnett County.
- Centene is an equal opportunity employer, committed to diversity and inclusion in the workplace. 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 any other characteristic protected by law.
- Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
- No relocation assistance or employment sponsorship is available for this role.
- Join an organization recognized for its commitment to employee growth, flexibility, and community impact. Apply now by clicking the job application button to become a valued member of our Provider Account Manager team in Georgia!