Account Manager

• Develops and maintains positive provider relationships with the provider community by regular on-site and/or virtual/digital visits
• Communicates administrative and programmatic changes and facilitates education
• Researches, analyzes, and coordinates prompt resolution to complex provider issues and appeals through direct contact with providers and internal matrixed partners
• Collaborates within a cohort of internal matrix partners to triage issues and submit work requests
• Assigned to a portfolio of providers within a defined cohort
• Coordinates Joint Operation Committees (JOC) of provider groups and drives meetings
• Assists with Annual Provider Satisfaction Surveys, corrective action plan implementation and monitoring education, contract questions and non-routine claim issues
• Coordinates communications on administrative and medical policy, reimbursement, and provider utilization patterns
• Conducts proactive outreach to support understanding of managed care policies, initiatives and programs
• Participates in external Provider Townhalls/Seminars and attends State Association conferences
• Identifies and reports on provider utilization patterns and researches issues impacting contract negotiations or network retention

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