Provider Network Account Manager II
L.A. Care Health Plan
full-time
Posted on:
Location Type: Office
Location: Los Angeles • California • United States
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Salary
💰 $77,265 - $123,625 per year
About the role
- Responsible for all aspects of the L.A. Care (LAC) provider contracting and relationship management process
- Drafting, reviewing, negotiating and implementing phases of contracts
- Building, nurturing, and maintaining positive working relationships between LAC and its network of providers
- Responsible for representing LAC in their partnership with contracted and non-contracted providers
- Responsible for maintaining an understanding of LAC governing regulations, policies and procedures
- Monitoring and managing network adequacy by assuring appropriate access to services throughout L.A. County
- Responsible for the initial on-board training of new managed care contract provider partners
- Responsible for identifying, and contacting, providers and/or provider organizations that are interested in participating with LAC
- Draft contract clauses/addenda, review, and negotiate new contracts/amendments and other contracting related documents
- Act as the liaison between PNM and other internal Plan departments
- Responsible for supporting the credentialing and re-credentialing process
Requirements
- Bachelor's Degree
- At least 3 years of experience in contracting and/or regulatory analysis in managed care or healthcare industry
- At least 3 years of healthcare experience in Managed Care; or, with a physician group, clinical-based organization, and/or in a hospital/facility setting
- Good organizational skills and demonstrate excellent attention to detail and follow up skills
- Knowledgeable financial and financial risk analysis
- Competent computer skills; MS Office skills required
- Must have excellent written and verbal communications skills and the ability to communicate effectively with management and non-management personnel, and LAC provider network physicians
- Possess a professional and mature demeanor at all times
- Ability to work in a fast-paced department independently and handle multiple tasks; work with interruptions and deal effectively with confidential information
- Proven ability to work with a diverse group of people, including physicians, support staff, coworkers and management.
- Demonstrated ability to research issues and bring about resolution either directly or with the assistance of others.
Benefits
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
contract draftingcontract negotiationregulatory analysisfinancial risk analysiscredentialingmanaged carehealthcare experienceattention to detailorganizational skillscomputer skills
Soft Skills
communication skillsrelationship managementproblem-solvingability to work independentlyability to handle multiple tasksprofessional demeanorinterpersonal skillsteam collaborationconfidentialityadaptability
Certifications
Bachelor's Degree