Provider Engagement Account Manager
November 27
Description
• Maintain partnerships between the health plan and the contracted provider networks • Build client relations to ensure delivery of the highest level of care • Engage with providers to align on network performance opportunities • Triages provider issues for resolution to internal partners • Investigate, resolve and communicate provider claim issues • Educate providers regarding policies and procedures related to referrals and claims submission • Performs other duties as assigned
Requirements
• 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
Benefits
• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules
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