Account Manager, Provider Relations - Multicultural Market/South Asian

Posted:
9/17/2024, 2:36:11 AM

Location(s):
New York, United States ⋅ New York, New York, United States

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Sales & Account Management

Overview

Manages all aspects of provider relations within a specified geographic region. Regularly visits and maintains ongoing contact with existing/potential providers for relationship building, recruitment, credentialing, re-credentialing and assisting with provider issues and education. Works under general supervision.

Compensation Range:$30.71 - $38.41 Hourly

What We Provide

  • Referral bonus opportunities
  • Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays  
  • Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability   
  • Employer-matched retirement saving funds  
  • Personal and financial wellness programs   
  • Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care    
  • Generous tuition reimbursement for qualifying degrees  
  • Opportunities for professional growth and career advancement   
  • Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities    
  • Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals.

What You Will Do

  • Manages all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.
  • Prepares materials for and orient providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.
  • Collaborates with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.
  • Monitors contract performance of network providers and serves as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.
  • Coordinates provider site visits, as needed.
  • Coordinates and attends meetings to serve as a resource and addresses provider issues.
  • Updates and maintains provider manuals with current Health Plan policies and procedures.
  • Updates and proofs provider directories.
  • Assists providers in triaging billing and claims disputes.
  • Participates and collaborates with Compliance on Department of Health and internal audits.
  • Participates in special projects and performs other duties as assigned.

Qualifications

Licenses and Certifications:
Drivers license required

Education:
Bachelor's Degree or equivalent related work experience, preferably in health care setting required

Work Experience:
Minimum three years health care experience required Knowledge of government programs, including Medicare and Medicaid preferred Prior experience in Provider Relations preferred