As a Provider Engagement Account Manager, you will enhance healthcare delivery by fostering relationships with providers to improve performance, optimize care, and ensure the highest quality for members. This role involves data analytics, in-person visits, and strategic planning to drive better patient outcomes.
Key Responsibilities
Maintain partnerships between health plan and contracted provider networks
Conduct regular in-person visits with physicians to discuss performance metrics
Collaborate with physicians on value-based care model initiatives
Utilize data analytics to track provider performance
Resolve provider-related issues and claims
Educate providers on policies and procedures
Manage network performance for assigned territory
Evaluate and develop strategic plans for provider performance improvement
Drive performance in risk, health benefit ratio, and quality measures
Complete special projects as assigned
Ability to travel locally 4 days a week
Required Qualifications
Bachelor’s degree in related field or equivalent experience
Two years of managed care or medical group experience
Experience in provider relations, quality improvement, claims, contracting utilization management, or clinical operations
Project management experience
Proficient in HEDIS/Quality measures
Benefits & Perks
Competitive payHealth insurance401K and stock purchase plansTuition reimbursementPaid time off plus holidaysFlexible work schedules