Provider Relationship Account Mgr Sr (US)
Company: Elevance Health
Location: Shepherdstown
Posted on: January 27, 2023
Job Description:
Provider Relationship Account Mgr Sr (US)
- Job Family: PND > Provider Relationship Account Mgmt
- Type: Full time
- Date Posted:Jan 18, 2023
- Req #: JR47253Location:
- WV, Charleston
- West Virginia, Morgantown
- West Virginia, Martinsburg
- West Virginia, Beckley
- West Virginia, Shepherdstown
- West Virginia, Ravenswood
- West Virginia, ParkersburgDescriptionJob Description
- Must be located in West Virginia
- Responsible for providing quality, accessible and comprehensive
service to the company's provider community.
- Develops and maintains positive provider relationships with
provider community by regular on-site and/or virtual/digital
visits, communicating administrative and programmatic changes, and
facilitating education and the resolution of provider issues.
- Serves as a knowledge and resource expert regarding complex
provider issues impacting provider satisfaction; research,
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.
- Generally, is assigned to a portfolio of providers within a
defined cohort.
- Coordinates Joint Operation Committees (JOC) of provider
groups, driving the meetings in the discussion of issues and
changes.
- May assist with Annual Provider Satisfaction Surveys, required
corrective action plan implementation and monitoring education,
contract questions and non-routine claim issues.
- Coordinates communications process on such issues as
administrative and medical policy, reimbursement and provider
utilization patterns.
- Conducts proactive outreach to support the understanding of
managed care policies and procedures, as well as on a variety of
initiatives and programs.
- Identifies and reports on provider utilization patterns which
have a direct impact on the quality-of-service delivery.
- Organizes and executes external Provider Town Halls/Seminars
and attends State Association conferences (e.g.: MGMA, AFP, AAP,
HFMA).
- Research complex issues that may impact future provider
contract negotiations or jeopardize network retention.
- May be responsible for monitoring department metrics, provider
assignments and oversight of daily activities and provide feedback
to manager on performance management, day-to-day training,
guidance, and workflow of Provider Relationship Account Mgt.
Consultants/Managers.Minimum Requirements Requires a bachelors
degree; a minimum of 5 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. Travel is required,
potentially up to 90-100% of the business week.Preferred Experience
Prior provider relations with MedicaidPlease be advised that
Elevance Health only accepts resumes from agencies that have a
signed agreement with Elevance Health. Accordingly, Elevance Health
is not obligated to pay referral fees to any agency that is not a
party to an agreement with Elevance Health. Thus, any unsolicited
resumes, including those submitted to hiring managers, are deemed
to be the property of Elevance Health.Be part of an Extraordinary
TeamElevance Health is a health company dedicated to improving
lives and communities and making healthcare simpler. Previously
known as Anthem, Inc., we have evolved into a company focused on
whole health and updated our name to better reflect the direction
the company is heading.We are looking for leaders at all levels of
the organization who are passionate about making an impact on our
members and the communities we serve. You will thrive in a complex
and collaborative environment where you take action and ownership
to solve problems and lead change. Do you want to be part of a
larger purpose and an evolving, high-performance culture that
empowers you to make an impact?We offer a range of
market-competitive total rewards that include merit increases, paid
holidays, Paid Time Off, and incentive bonus programs (unless
covered by a collective bargaining agreement), medical, dental,
vision, short and long term disability benefits, 401(k) +match,
stock purchase plan, life insurance, wellness programs and
financial education resources, to name a few.The health of our
associates and communities is a top priority for Elevance Health.
We require all new candidates to become vaccinated against
COVID-19. If you are not vaccinated, your offer will be rescinded
unless you provide and Elevance Health approves a valid religious
or medical explanation as to why you are not able to get vaccinated
that Elevance Health is able to reasonably accommodate. Elevance
Health will also follow all relevant federal, state and local
laws.Elevance Health has been named as a Fortune Great Place To
Work in 2021, is ranked as one of the 2021 Worlds Most Admired
Companies among health insurers by Fortune magazine, and a Top 20
Fortune 500 Companies on Diversity and Inclusion. To learn more
about our company and apply, please visit us at
careers.ElevanceHealth.com. Elevance Health is an Equal Employment
Opportunity employer and all qualified applicants will receive
consideration for employment without regard to age, citizenship
status, color, creed, disability, ethnicity, genetic information,
gender (including gender identity and gender expression), marital
status, national origin, race, religion, sex, sexual orientation,
veteran status or any other status or condition protected by
applicable federal, state, or local laws. Applicants who require
accommodation to participate in the job application process may
contact ability@icareerhelp.com for assistance.EEO is the LawEqual
Opportunity Employer / Disability / Veteran Please use the links
below to review statements of protection from discrimination under
Federal law for job applicants and employees.
- EEO Policy Statement
- EEO is the Law Poster
- EEO Poster Supplement-English Version
- Pay Transparency
- Privacy Notice for California Residents Elevance Health, Inc.
is an E-verify Employer Need Assistance?Email us
(elevancehealth@icareerhelp.com) or call 1-877-204-7664
Keywords: Elevance Health, Germantown , Provider Relationship Account Mgr Sr (US), Other , Shepherdstown, Maryland
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