Provider Relations Account Manager

CareSource•Mobile, AL

46d

About The Position

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

Requirements

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
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
Employment in this position is conditional pending successful clearance of a driver’s license record check.
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
A valid driver’s license, car, and insurance are necessary for work related travel

Nice To Haves

Experience in a managed care organization is preferred

Responsibilities

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