WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card, send you a check, or ask you for payment as part of consideration for employment.Provider Relationship Account Manager
Job Family: PND > Provider Relationship Account Mgmt
Type: Full time
Date Posted:Feb 07, 2024
Anticipated End Date:Feb 29, 2024
Reference: JR104884
Location:
NJ, ISELIN
New Jersey
DescriptionLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of Iselin, NJ Elevance Health PulsePoint office.The Provider Relationship Account Manager is responsible for providing quality, accessible and comprehensive service to the company's provider community. Develops and maintains positive provider relationships with the 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.How you will make an impact:
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 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.
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 quality-of-service delivery.
Research issues that may impact future provider contract negotiations or jeopardize network retention.
Will review complex data for actionable steps for issue resolution and analyze quality provider data Assigned to a subset of the network via the Alliance Partner program and acts as a single point of contact for those providers.
Understands the relative measures to address in the market and drives VBP contracts/conversations.
Ability to identify complex provider issues for resolution and submit necessary tickets/requests to resolve issue.
Responds to requests from clinical, G&A and providers.
Meet with key internal stakeholders and providers to resolve issues.
Minimum Requirements:
Requires a bachelor’s 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.
Preferred Requirements:
Travels to worksite and other locations as necessary.
Proficient with Microsoft Office to include Word, Excel, and PowerPoint.
Excellent written and verbal communications skills.
Ability to develop, prioritize and accomplish goals.
Strong interpersonal skills and high level of professionalism.
Effective listening and critical thinking skills.
Effective problem-solving skills with attention to detail.
Ability to work independently and within a team.
Excellent leadership skills.
Ability to create and maintain excellent working relationships.
For candidates working in person or remotely in the below locations, the salary range for this specific position is $72,220 to $90,275.Locations: Jersey City, NJIn addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .
The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
Please 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 AreElevance 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 WorkAt 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 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.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 1-hour 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/member-facing roles to become vaccinated against COVID-19. 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 elevancehealthjobssupport@elevancehealth.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.
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