Provider Engagement Account Executive

Centene Corporation • Remote-KY, MI

2d • $87,700 - $157,800

About The Position

The Provider Engagement Account Executive develops and maintains strategic partnerships between the health plan and contracted provider networks to advance value-based care initiatives, improve provider performance, and enhance member outcomes. The role serves as a trusted advisor to providers and internal stakeholders by delivering data-driven insights, operational support, and performance improvement strategies. It contributes to network management, contracting, and value-based payment (VBP) program success through program administration, relationship management, analytics, education, and process optimization.

The position serves as the primary strategic partner and point of contact for hospital systems, multispecialty groups, and large primary care organizations participating in value-based and risk-based arrangements. It provides expertise and guidance on VBP program design, reporting tools, performance metrics, and financial methodologies; trains and supports provider organizations and health plan teammates; and manages the VBP contract portfolio, including operational issue resolution, data correction, and payment execution.

The Account Executive analyzes complex datasets with Excel, dashboards, and reporting tools; develops executive-level presentations; drives process improvement and operational efficiencies; and implements provider performance improvement strategies involving quality, pay-for-performance, cost, and utilization. The role also supports contracting strategy, interprets provider contract language, educates providers on operational policies and tools, and provides leadership and mentorship to provider-facing team members and external partners. Travel several days a week or as required is expected. The employee must be authorized to work in the U.S. without current or future employment-based visa sponsorship.

Requirements

• Bachelor’s degree in a related field or equivalent experience.
• Five or more years of managed care or medical group experience in provider relations, quality improvement, utilization management, or clinical operations.
• Project management experience in 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 across multiple organizational levels and multidisciplinary internal and external teams.
• High proficiency in HEDIS and quality measures, cost, and utilization.
• Ability to travel several days a week or as required.
• Must be authorized to work in the U.S. without the need for current or future employment-based visa sponsorship.

Nice To Haves

• Master’s degree preferred in Public Health (MOH), Health Administration (MHA), or Business Administration (MBA).

Responsibilities

• Serve as the primary strategic partner and point of contact for hospital systems, multispecialty groups, and large primary care organizations participating in value-based and risk-based arrangements.
• Provide subject-matter expertise and guidance on VBP program design, reporting tools, performance metrics, and financial methodologies.
• Deliver training, education, and ongoing support to provider organizations and health plan teammates on VBP programs, reporting, and operational processes.
• Manage and maintain the VBP contract portfolio, resolving operational issues, correcting data discrepancies, and supporting payment execution.
• Analyze complex datasets using Excel, dashboards, and reporting tools to identify performance trends, risks, and improvement opportunities.
• Develop and deliver executive-level presentations that turn provider performance data into actionable insights and recommendations.
• Drive VBP success through process improvement initiatives, operational efficiencies, and development of best-practice playbooks.
• Execute provider performance improvement strategies across quality, pay-for-performance, cost, and utilization initiatives by evaluating performance, developing action plans, and monitoring progress toward established goals.
• Build and maintain relationships with provider leaders, executive stakeholders, and cross-functional internal teams.
• Support contracting strategy by providing insights on provider relationships, market dynamics, and organizational considerations that affect negotiations and performance outcomes.
• Review, interpret, and apply value-based and provider contract language to support operational execution and issue resolution.
• 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 with internal partners and create efficiencies to prevent recurring concerns.
• Perform other duties as assigned and maintain compliance with organizational policies, standards, and regulatory requirements.

Benefits

• Competitive pay
• Health insurance
• 401K
• Stock purchase plans
• Tuition reimbursement
• Paid time off
• Holidays
• Flexible approach to work with remote, hybrid, field, or office work schedules
• Additional forms of incentives may be included in total compensation, subject to program eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior