Provider Network Account Manager
United States
Full Time
Experienced
Bright Vision Technologies is a forward-thinking software development company dedicated to building innovative solutions that help businesses automate and optimize their operations.
We leverage cutting-edge technologies to create scalable, secure, and user-friendly applications. As we continue to grow, we’re looking for a skilled Provider Network Account Manager join our dynamic team and contribute to our mission of transforming business processes through technology.
This is a fantastic opportunity to join an established and well-respected organization offering tremendous career growth potential.
Job Title: Provider Network Account Manager
Location: Georgia – Candidates must reside in Bartow, Cherokee, Floyd, or Pickens counties
Job Type: Full-Time
Work Model: Field-based (local travel required up to 4 days per week)
Position Purpose
This role is responsible for building and maintaining strong partnerships between the health plan and contracted provider networks. The Provider Engagement Manager serves as the primary liaison between providers and the health plan, driving performance improvement across quality, cost, utilization, and value-based care initiatives.
Key Responsibilities
Provider Relationship & Account Management
Education & Experience
Compensation & Benefits
Centene offers a comprehensive benefits package including:
Would you like to know more about this opportunity? For immediate consideration, please send your resume to [email protected] or contact us at (908) 650-6382
Bright Vision Technologies, we are committed to equal employment opportunities and fostering an inclusive work environment. If you require accommodations during the recruitment process, please let us know.
We leverage cutting-edge technologies to create scalable, secure, and user-friendly applications. As we continue to grow, we’re looking for a skilled Provider Network Account Manager join our dynamic team and contribute to our mission of transforming business processes through technology.
This is a fantastic opportunity to join an established and well-respected organization offering tremendous career growth potential.
Job Title: Provider Network Account Manager
Location: Georgia – Candidates must reside in Bartow, Cherokee, Floyd, or Pickens counties
Job Type: Full-Time
Work Model: Field-based (local travel required up to 4 days per week)
This role is responsible for building and maintaining strong partnerships between the health plan and contracted provider networks. The Provider Engagement Manager serves as the primary liaison between providers and the health plan, driving performance improvement across quality, cost, utilization, and value-based care initiatives.
Provider Relationship & Account Management
- Serve as the primary point of contact for assigned providers
- Build strong, consultative relationships to ensure high-quality care delivery
- Conduct regular in-person physician visits to provide real-time support and guidance
- Perform provider orientations and ongoing education, including updating training materials
- Triage and resolve provider issues in collaboration with internal teams
- Investigate, resolve, and communicate provider claims issues
- Initiate and maintain accurate provider demographic data updates
- Educate providers on referrals, claims submission, EDI, website tools, and policies
- Manage network performance using a consultative, data-driven approach
- Evaluate provider performance and develop improvement strategies
- Drive performance in key areas including:
- HEDIS / Quality Measures
- Risk / Pay-for-Quality (P4Q)
- Medical Loss Ratio (MLR) / Health Benefit Ratio (HBR)
- Cost and utilization management
- Support and align providers with value-based care model initiatives
- Complete special projects as assigned
- Travel locally up to 4 days per week
- Perform other duties as required
- Ensure compliance with all policies, standards, and regulations
- Bachelor’s degree in a related field or equivalent experience
- 2+ years of provider engagement or account management experience
- Project management experience in a medical group, IPA, or health plan setting
- Strong working knowledge of:
- HEDIS / Quality metrics
- Cost and utilization management
- Value-based care models
Centene offers a comprehensive benefits package including:
- Competitive base pay
- Medical, dental, and vision insurance
- 401(k) and employee stock purchase plans
- Tuition reimbursement
- Paid time off and holidays
- Flexible work arrangements (field, hybrid, or office-based as applicable)
Would you like to know more about this opportunity? For immediate consideration, please send your resume to [email protected] or contact us at (908) 650-6382
Bright Vision Technologies, we are committed to equal employment opportunities and fostering an inclusive work environment. If you require accommodations during the recruitment process, please let us know.
Equal Employment Opportunity (EEO) Statement
Bright Vision Technologies (BV Teck) is committed to equal employment opportunity (EEO) for all employees and applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, veteran status, or any other protected status as defined by applicable federal, state, or local laws. This commitment extends to all aspects of employment, including recruitment, hiring, training, compensation, promotion, transfer, leaves of absence, termination, layoffs, and recall.
BV Teck expressly prohibits any form of workplace harassment or discrimination. Any improper interference with employees' ability to perform their job duties may result in disciplinary action up to and including termination of employment.
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