Provider Relationship Account Manager
Elevance Health
Provider Relationship Account Manager – Escalation Advocate
Elevance Health
full-time
Posted on:
Origin: • 🇺🇸 United States • California, New York
Visit company websiteSalary
💰 $69,048 - $118,368 per year
Job Level
Mid-LevelSenior
About the role
- 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
Requirements
- Requires a bachelor’s degree
- Minimum of 3 years of customer service experience including 2 years of experience in a healthcare or provider environment
- Or any combination of education and experience, which would provide an equivalent background
- Travels to worksite and other locations as necessary
- Provider interface experience strongly preferred
- Maryland Medicaid or Public Sector Medicaid account knowledge strongly preferred
- Per hybrid/virtual work policy, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law
- May require COVID-19 and Influenza vaccination for certain patient/member-facing roles (offer may be rescinded without acceptable explanation)
