Provider Relationship Account Manager
Provider Relationship Account Manager
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Job Description
Anticipated End Date:
Position Title:
Provider Relationship Account ManagerJob Description:
Provider Relationship Account Manager
Carelon Behavioral Health
Location: This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Ohio Elevance Health PulsePoint locations.
Shift: Monday Friday normal business hours
A proud member of the Elevance Health family of companies Carelon Behavioral Health formerly Beacon Health Options offers superior clinical mental health and substance use disorder management a comprehensive employee assistance program work/life support specialty programs for autism and depression and insightful analytics to improve the delivery of care.
The Provider Relationship Account Manager is responsible for providing quality accessible and comprehensive service to the companys provider community.
How you will make an impact:
- Develops and maintains positive provider relationships with the provider community by regular onsite 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 provider issues impacting provider satisfaction and network retention; 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.
- 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 Annual Provider Satisfaction Surveys required corrective action plan implementation and monitoring education contract questions and nonroutine 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.
- Participates in external Provider Townhalls/Seminars and attends State Association conferences (e.g.: MGMA AFP AAP HFMA).
- Identifies and reports on provider utilization patterns which have a direct impact on the qualityofservice delivery.
- Research issues that may impact future provider contract negotiations or jeopardize network retention.
Minimum Requirements:
- Requires a bachelors 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.
Preferred Skills Capabilities and Experiences:
- Experience with medical Claims preferred.
- Experience using Microsoft Excel in including creation of pivot tables preferred.
Job Level:
NonManagement ExemptWorkshift:
1st Shift (United States of America)Job Family:
PND > Provider Relationship Account MgmtPlease be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes including those submitted to hiring managers are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy power our business outcomes and drive our shared success for our consumers our associates our communities and our business.
We offer a range of marketcompetitive 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.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager associates are required to work at an Elevance Health location at least once per week and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/memberfacing roles to become vaccinated against COVID19 and Influenza. If you are not vaccinated your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal state and local laws.
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 for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Required Experience:
Manager
Employment Type
Full-Time
