Provider Engagement Account Manager (Remote – GA Based)
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Job Location:
Lawrenceville, NJ - USA
Monthly Salary:
Not Disclosed
Posted on:
10 hours ago
Vacancies:
1 Vacancy
Job Summary
We are seeking a consultative Provider Engagement Account Manager to join a leading national health plan. This role is responsible for maintaining strategic partnerships with contracted provider networks and driving optimal network performance through a consultative account management approach. The successful candidate will be accountable for improving contract incentives quality outcomes and cost utilization.
Essential Duties & Responsibilities:
Direct Provider Engagement: Conduct regular in-person visits with physicians to provide real-time support discuss performance metrics and identify opportunities for improvement in patient care.
Relationship Management: Serve as the primary contact for providers and act as a liaison between the providers and the health plan. Receive and effectively respond to external provider-related issues triaging them with internal partners as needed.
Performance Improvement: Evaluate provider performance and develop strategic plans to improve performance in key areas including: Risk/P4Q Health Benefit Ratio (HBR) HEDIS/quality and cost utilization.
Value-Based Care: Focus on value-based care model initiatives collaborating with physicians to align with performance-based agreements.
Compliance: Ensure compliance with all policies and standards
Qualifications :
Education & Experience (Required):
Bachelors degree in a related field or equivalent experience.
Minimum of two (2) years of provider engagement or account management experience at a medical group IPA or health plan setting.
- Project management experience is highly preferred.
Key Skills & Competencies:
- Proficient in HEDIS/Quality measures cost (MLR) and utilization metrics.
- Strong interpersonal skills to build client relations and ensure the delivery of the highest level of care.
- Demonstrated ability to evaluate provider performance and develop strategic plans.
Must be able to manage provider performance for an assigned territory through a consultative approach.
Additional Information :
Location and Work Environment:
Mandatory Location: Due to travel requirements we are seeking candidates who live specifically in Cobb Dekalb Fulton or Gwinnett County.
Travel: This is a field-based role requiring local travel up to four (4) days a week.
Salary Range: The base salary range is USD $55000 to $99000 per year.
About Our Client and Benefits:
- Our client is a diversified national organization committed to transforming the health of our communities.
- Total compensation may include additional forms of incentives.
Benefits include: health insurance 401K and stock purchase plans tuition reimbursement paid time off plus holidays and a flexible approach to work.
Remote Work :
Yes
Employment Type :
Full-time
Key Skills
- Business Development
- Employee Orientation
- Public Health
- Account Management
- VersionOne
- Conflict Management
- Project Management
- Relationship Management
- Team Management
- Customer relationship management
- Human Resources
- Public Speaking
About Company
CRD Careers brings over 20 years of expertise in leadership, mentoring, and talent acquisition to this passion-driven mission. Our goal is not only to break down gender and racial barriers but to empower organizations of all sizes with a Creative, Resourceful, and Diverse approach.At ... View more
