C

Centene

Runs government-backed health insurance plans

Provider Engagement Account Manager

Full-TimeUpdated
$56.2k - $101k/yr
Junior
Bachelor's
Georgia, USA
RemoteCandidates must reside in Fannin, Gilmer, Union, or Lumpkin County, Georgia.
Customer Experience & SupportCustomer Success

About the job

Requirements
  • A bachelor's degree in a related field or equivalent experience.
  • Two years of experience in managed care or medical groups, provider relations, quality improvement, claims, contracting, utilization management, or clinical operations.
  • Project management experience in a medical group, independent practice association, or health plan setting.
  • Proficiency in HEDIS and quality measures, cost, and utilization.
  • Ability to travel locally four days a week.
  • Must reside in Fannin, Gilmer, Union, or Lumpkin County, Georgia.
Responsibilities
  • Maintain partnerships between the health plan and contracted provider networks serving the communities.
  • Build client relations to support delivery of high-quality care to members.
  • Engage providers to align on network performance opportunities and solutions, using consultative account management and accountability for issue resolution.
  • Drive optimal performance in contract incentives, quality, and cost utilization.
  • Serve as the primary contact for providers and liaison between providers and the health plan.
  • Triage provider issues and coordinate resolution with internal partners.
  • Receive and respond effectively to external provider-related issues.
  • Investigate, resolve, and communicate provider claim issues and changes.
  • Initiate data entry for provider demographic information changes.
  • Educate providers on policies and procedures for referrals, claims submission, website usage, electronic data interchange solicitation, and related topics.
  • Conduct provider orientations and ongoing provider education, including writing and updating orientation materials.
  • Manage network performance for the assigned territory through a consultative account-management approach.
  • Evaluate provider performance and develop strategic plans to improve performance.
  • Drive provider performance improvement in risk/P4Q, health benefit ratio, HEDIS and quality, cost, and utilization.
  • Complete special projects as assigned.
  • Perform other assigned duties and comply with policies and standards.
  • Travel regularly throughout the broader North Georgia territory.
Desired Qualifications
  • Knowledge of risk adjustment and value-based care.

About the company

Centene runs government-backed health insurance plans in the United States, with Medicaid as its largest business alongside Medicare and Affordable Care Act Marketplace coverage. It is one of the largest Medicaid insurers in the country and also runs plans for people eligible for both Medicare and Medicaid, long-term care and children in foster care. States and the federal government pay Centene a set amount per member to manage care, and individuals buy its Ambetter Marketplace plans, often with federal subsidies. Centene contracts with local doctors, hospitals and pharmacies and keeps the difference between premiums and the cost of care. The company was founded in 1984 in Milwaukee and is headquartered in Clayton, Missouri.

Company Size

10,001+

Company Stage

IPO

Headquarters

Clayton, MO

Founded

1984

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Simplify Jobs

Simplify's Take

What believers are saying

  • Profits are recovering: July 2026 results lifted full-year adjusted EPS guidance above $4.80.
  • Revenue keeps growing: second-quarter revenue reported in July 2026 rose nearly 10% to about $53.6 billion.
  • Large employer, many paths: Centene had 59,800 employees in June 2026 across Medicaid, Medicare and Marketplace plans.

What critics are saying

  • Job security is shaky: in June 2026 Centene offered buyouts to most employees after steep membership losses.
  • Exchange enrollment is shrinking: Marketplace members fell from about 5.9 million in June 2025 to 3.5 million in June 2026.
  • Revenue rides on Medicaid rolls: enrollment fell 5.5% in a year to 12.1 million by June 2026.

What makes Centene unique

  • Government coverage is the whole business: Centene serves more than 1 in 15 Americans across all 50 states.
  • It began as a safety-net plan: a former hospital bookkeeper founded it in 1984 to serve Milwaukee's low-income patients.
  • It runs specialty Medicaid: its Superior HealthPlan has been Texas's sole foster care insurer since 2008.

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Benefits

  • Health Insurance
  • 401(k) Retirement Plan
  • 401(k) Company Match
  • Paid Vacation
  • Hybrid Work Options
  • Flexible Work Hours

Company News

DistilInfo
Oct 29th, 2026
Centene names Jeff Davis Louisiana Medicaid CEO.

Centene names Jeff Davis Louisiana Medicaid CEO. Louisiana Medicaid CEO Jeff Davis has joined Centene's Louisiana Healthcare Connections as plan president and chief executive, according to an Oct. 28, 2026, LinkedIn announcement reported by Becker's Payer Issues. Davis succeeds James Schlottman, who announced his retirement in May after more than 15 years with the Medicaid health plan. Centene has not disclosed financial terms associated with the appointment. The leadership change affects one of Louisiana's major Medicaid managed care organizations, which serves approximately 400,000 members and works with about 30,000 providers, according to Centene. For hospitals, physicians and state officials, the appointment comes as the insurer manages provider contracting, Medicaid coverage requirements and access to care across Louisiana. Louisiana Medicaid CEO Jeff Davis appointed. Davis announced his new position at Louisiana Healthcare Connections through an Oct. 28 LinkedIn post. The appointment places him in charge of a Centene subsidiary responsible for administering Medicaid coverage and managing relationships with participating healthcare providers. The company has not publicly detailed his immediate strategic priorities or announced specific operational changes accompanying the transition. According to Centene's Louisiana operations overview, Louisiana Healthcare Connections serves approximately 400,000 Medicaid members statewide. The plan works with an estimated 30,000 providers, including hospitals, physician practices and other healthcare organizations. Centene identifies it as the state's largest Medicaid health plan. Centene established its Louisiana operations in 2006 and maintains a presence in Baton Rouge, Covington and Lafayette. The company's state overview lists 687 employees as of Sept. 30, 2026. Its Louisiana business includes Medicaid coverage through Louisiana Healthcare Connections and Medicare products offered under the Wellcare brand. The new plan president will oversee an organization operating within Louisiana's publicly funded healthcare system. Centene's published job description for the position identifies responsibilities involving operational policies, regulatory compliance and relationships with government agencies and healthcare partners. However, the company has not announced whether Davis will introduce changes to its existing management structure. New executive previously led Missouri plan. Before joining Louisiana Healthcare Connections, Davis served as plan president of Healthy Blue in Missouri. The organization emerged from a collaboration involving Elevance Health's Missouri Care and Blue Cross and Blue Shield of Kansas City. His previous position involved leadership within the Medicaid managed care sector, according to the Oct. 29 report. Healthy Blue operates in a market where managed care organizations coordinate healthcare coverage for eligible Medicaid beneficiaries. The experience provides Davis with a background in state-sponsored health insurance operations. However, the announcement did not specify his length of service in Missouri or provide detailed performance information from his previous role. Davis replaces James Schlottman, who announced his retirement in May 2026. Schlottman had spent more than 15 years with Louisiana Healthcare Connections and previously held positions at Humana, Blue Cross and Blue Shield of Louisiana and UnitedHealthcare. His retirement was reported May 15, following a LinkedIn announcement the previous day. Schlottman indicated that he planned to spend time with family and travel following his departure, while leaving open the possibility of future professional opportunities. Centene has not publicly identified a detailed transition timetable or disclosed how long the leadership position remained vacant. The appointment nevertheless establishes a new executive responsible for the insurer's Louisiana Medicaid operations. Provider contracting remains operational priority. The leadership transition comes as Louisiana Healthcare Connections manages its relationship with Ochsner Health System, one of the state's largest healthcare providers. In September, the insurer warned that parts of Ochsner's network could become unavailable to members beginning Dec. 1 if the organizations failed to reach a new agreement. The potential change raised concerns about continuity of care for affected Medicaid beneficiaries. In an Oct. 23 company update, Louisiana Healthcare Connections announced that the two organizations had reached an agreement in principle on a new contract. The insurer said the proposed arrangement would support quality improvement and care coordination while allowing Medicaid members to continue receiving in-network services from Ochsner. Both organizations were working to finalize the agreement. The company did not disclose the proposed contract's financial terms or confirm that all outstanding negotiations had concluded. Its earlier communications indicated that the existing agreements were approximately 15 years old. Louisiana Healthcare Connections said the negotiations were intended to update the framework governing care coordination, quality measurement and provider relationships. The network discussions are relevant to the new executive's responsibilities, although Centene has not specifically connected Davis' appointment to the Ochsner negotiations. Provider contracting can affect access to hospitals, specialists and other medical services for managed Medicaid members. The insurer's October update indicates that maintaining network participation remains an active operational consideration. What comes next. Davis assumes leadership as Louisiana continues its Medicaid managed care contracting arrangements. In October, state lawmakers approved contract renewals involving four managed care organizations serving Medicaid beneficiaries. Louisiana Healthcare Connections was among the participating insurers, alongside Aetna, AmeriHealth Caritas and Humana, according to reporting on the state's budget committee proceedings. The renewals represent a significant component of Louisiana's healthcare financing system. State officials reported that managed Medicaid contracts would account for more than $16 billion in spending during calendar year 2027. These expenditures cover multiple organizations and should not be interpreted as revenue attributable solely to Louisiana Healthcare Connections. For the incoming Louisiana Medicaid CEO, near-term responsibilities include overseeing ongoing plan operations, regulatory obligations and relationships with providers and state officials. The insurer must also continue communicating with members and participating healthcare organizations as contracting arrangements are finalized. Centene has not announced new membership targets, financial projections or a revised strategy associated with Davis' appointment. The leadership transition occurs amid broader executive changes across Centene's insurance businesses. In April 2026, the company named Daniel Finke group president of markets and commercial, overseeing Medicaid and commercial operations, and expanded Michael Carson's responsibilities as group president of Medicare and specialty. Davis' appointment adds a new state-level leader as the company continues operating its government-sponsored health plans. Future announcements may clarify Davis' priorities for Medicaid access, provider partnerships and plan performance in Louisiana. For healthcare executives, the immediate development is a confirmed leadership change at a health plan serving hundreds of thousands of Medicaid beneficiaries. Any operational effects will depend on decisions made after the transition rather than the appointment alone.

Yahoo Finance
Oct 27th, 2026
Centene raises 2026 outlook to over $5.20 EPS as Medicare beats and debt falls to $15.0B

Centene raised its 2026 earnings outlook after third-quarter results beat expectations. The health insurer reported adjusted earnings per share of $0.58 and $45.1 billion in premium and service revenue. It now expects full-year adjusted earnings per share of more than $5.20, up from more than $4.80. Stronger Medicare results drove the change, and Medicare Advantage is now expected to break even in 2026, a year earlier than planned. Medicaid performed in line with expectations, with membership at 11.9 million. Marketplace margins are expected at the top of the 4.5% to 5% range. Total debt fell to $15.0 billion from $18.5 billion at the end of 2024. Centene will give formal 2027 guidance in February.

Yahoo Finance
Oct 27th, 2026
Centene's Medicare Advantage hits breakeven a year early as debt falls to $15.0B from $18.5B

Centene reported its Medicare Advantage business reached breakeven in 2026, a year ahead of plan, helped by favourable medical costs. Medicaid held steady with a 93.6% health benefits ratio, and Marketplace pretax margin hit the top of its 4.5% to 5.0% range. The company cut total debt to $15.0 billion from $18.5 billion at the end of 2024. It booked $276 million in severance-related charges in the third quarter as part of a $480 million optimisation programme that includes job cuts and AI-driven automation. For 2027, Centene expects Medicare Advantage membership to fall as it exits less profitable areas. It is also leaving the Health Net commercial group business in California over 18 to 24 months. Adjusted earnings per share guidance for 2026 stands at $5.20, including about $0.50 of non-recurring benefits.

Yahoo Finance
Oct 27th, 2026
Centene cuts almost 6,000 jobs as Medicare break-even comes a year early

Centene expects to break even in its Medicare business this year, a target it had not planned to hit until 2027. The St. Louis-based insurer cut Medicare Advantage and prescription drug plan costs in the third quarter. It raised its full-year outlook for the third time this year. Adjusted earnings per share are now forecast at "greater than" $5.20, up from "greater than" $4.80. Third-quarter revenue rose 2% to $50.6 billion. The net loss narrowed to $71 million from $6.6 billion a year earlier, when Centene took a large impairment charge. Headcount fell from 59,800 to 53,900 after layoffs and a voluntary separation program. Severance cost almost $280 million, but executives expect the cuts to help margins in 2027.

RamaOnHealthcare
Oct 27th, 2026
Centene reports small loss as CEO says health insurer on track for 'faster recovery'

Centene reports small loss as CEO says health insurer on track for 'faster recovery' Forbes October 27, 2026 Bruce Japsen Centene reported a $71 million third quarter loss though much improved over the year-ago period as the health insurer gets a handle on costs dogging the industry. Centene, which is one of the nation's largest providers of Obamacare and is also a large provider of Medicaid health benefits for poor Americans, reported a $71 million loss or 14 cents in the third quarter ended Sept. 30. That compares to a loss of $6.6 billion, or $13.50 in the year ago period. Centene reported revenue of $50.65 billion in the period compared to $49.69 billion in the third quarter of last year. "Solid underlying fundamentals within our core businesses have powered a faster recovery to our earnings trajectory than previously anticipated,"...