Provider Relationship Account Manager – Escalation Advocate
Elevance Health
Provider Relationship Account Manager
Elevance Health
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Provide quality, accessible and comprehensive service to the company's provider community
- Develop and maintain positive provider relationships via regular on-site and/or virtual/digital visits
- Communicate administrative and programmatic changes and facilitate education and resolution of provider issues
- Serve as a knowledge and resource expert regarding provider issues impacting satisfaction and network retention
- Research, analyze, and coordinate prompt resolution to complex provider issues and appeals
- Collaborate with internal matrixed partners to triage issues and submit work requests
- Support an assigned portfolio of providers (hospitals, professional, ambulatory, ancillaries, FQHCs, etc.)
- Coordinate Joint Operation Committees (JOC) and drive meetings discussing issues and changes
- Assist with Annual Provider Satisfaction Surveys and corrective action plan implementation and monitoring
- Coordinate communications on administrative and medical policy, reimbursement, and provider utilization patterns
- Conduct proactive outreach to support understanding of managed care policies, procedures, initiatives and programs
- Participate in external Provider Townhalls/Seminars and attend state association conferences
- Identify and report on provider utilization patterns and research issues that may impact contract negotiations or network retention
Requirements
- Requires a bachelor’s degree; or any combination of education and experience which provides equivalent background
- Minimum of 3 years of customer service experience
- Minimum of 2 years of experience in a healthcare or provider environment
- Travels to worksite and other locations 30%–40% of the time
- Candidates must be within a reasonable commuting distance from Manchester, NH office unless an accommodation is granted
- Provider or customer-facing experience preferred
- May require COVID-19 and Influenza vaccination for certain patient/member-facing roles
