Job Summary:
The Provider Relations Account Manager is responsible for working in a highly matrixed organization and influencing internal stakeholder relationships. This role will engage with providers to build, manage and maintain relationships, with a strong focus on operational efficiencies, proactive engagement, and reduced burden which all leads to retention of provider relationships.
Essential Functions:
- Own the relationship with the Health Partner/Provider with a proactive focus on overall provider satisfaction and retention.
- Identify, solution, and execute on Health Partner/Provider escalations and systemic opportunities (including complex and/or non routine) for continuous operational improvement
- Prepare and lead internal and external meetings with key stakeholders
- Assure department deliverables are met with timely follow up
- Educate health partners/providers on, all operational updates
- Analyze current work processes, identify gaps and implement appropriate correction
- Responsible for maintaining strong internal relationships with key business partners
- Perform quality assurance reviews to ensure that provider information is loaded correctly and contracting terms are accurately operationalized.
- Perform provider outreach, field visits and site evaluations to ensure compliance with the provider contract, and state and federal requirements
- Develop and utilize key operational dashboards with providers
- Manage multiple projects, collect and analyze data and disseminate to appropriate departments as necessary
- Ensure appropriate documentation of interactions and projects
- Support Leadership in meeting annual goals
- Perform any other job duties as requested
Education and Experience:
- Bachelor’s Degree in Business Administration, or related field or equivalent years of relevant work experience is preferred
- A minimum of three (3) years of experience in the health plan/managed care industry is required
- Experience in a managed care organization is preferred
Competencies, Knowledge and Skills:
- Proficient with Microsoft Office to include Word, Excel and PowerPoint
- Excellent written and verbal communications skills
- Ability to develop, prioritize and accomplish goals
- Detail oriented
- Strong interpersonal skills and high level of professionalism
- Effective listening and critical thinking skills
- Effective problem-solving skills with attention to detail
- Ability to work independently and within a team
- Strong negotiation skills
- Excellent leadership skills
- Exceptional emotional intelligence
- Ability to create and maintain excellent working relationships
- Project management
- Conflict resolution
- Facilitation management
- Analytical skills
Licensure and Certification:
- Employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if you have started employment in this position, your employment in this position will be terminated
- To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
- CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process
Working Conditions:
- Mobile Worker: This is a mobile position, meaning that regular travel to different work locations is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time.
- Reside in the same territory they are assigned to work in; exceptions may be considered, due to business need
- May be required to travel greater than 50% of time to perform work duties. A valid driver’s license, car, and insurance are necessary for work related travel
- Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer
- Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our member and may refer members to other CareSource resources
Compensation Range:
$60,300.00 - $96,500.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.