Provider Relations Account Manager

Provider Relations Account Manager

Job Summary: The Provider Relations Account Manager is responsible for working in a highly matrixed organization and influencing internal stakeholder relationships. This role will engage with providers to build, manage, and maintain relationships, with a strong focus on operational efficiencies, proactive engagement, and reduced burden which all leads to retention of provider relationships.

Essential Functions:

• Own the relationship with the Health Partner/Provider with a proactive focus on overall provider satisfaction and retention.
• Identify, solution, and execute on Health Partner/Provider escalations and systemic opportunities (including complex and/or non routine) for continuous operational improvement.
• Prepare and lead internal and external meetings with key stakeholders.
• Assure department deliverables are met with timely follow up.
• Educate health partners/providers on all operational updates.
• Analyze current work processes, identify gaps and implement appropriate correction.
• Responsible for maintaining strong internal relationships with key business partners.
• Perform quality assurance reviews to ensure that provider information is loaded correctly and contracting terms are accurately operationalized.
• Perform provider outreach, field visits and site evaluations to ensure compliance with the provider contract, and state and federal requirements.
• Develop and utilize key operational dashboards with providers.
• Manage multiple projects, collect and analyze data and disseminate to appropriate departments as necessary.
• Ensure appropriate documentation of interactions and projects.
• Support Leadership in meeting annual goals.
• Perform any other job duties as requested.

Education and Experience: Bachelor's Degree in Business Administration, or related field or equivalent years of relevant work experience is preferred. A minimum of three (3) years of experience in the health plan/managed care industry is required. Experience in a managed care organization is preferred.

Competencies, Knowledge and Skills:

• Proficient with Microsoft Office to include Word, Excel and PowerPoint.
• Excellent written and verbal communications skills.
• Ability to develop, prioritize and accomplish goals.
• Detail oriented.
• 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.
• Strong negotiation skills.
• Excellent leadership skills.
• Exceptional emotional intelligence.
• Ability to create and maintain excellent working relationships.
• Project management.
• Conflict resolution.
• Facilitation management.
• Analytical skills.

Licensure and Certification: Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if you have started employment in this position, your employment in this position will be terminated.

To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment.