LTSS Provider Relations Account Manager-Must Travel to Dayton & Cincinnati Metro Areas

CareSource•Mobile, AL

20d•$83,000 - $132,800•Remote

About The Position

The LTSS Provider Relations Account Manager is responsible for working in a highly matrixed organization and influencing internal stakeholder relationships. This role will engage with LTSS and HCBS 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 and improving member access to care.

Requirements

Bachelor’s degree in project management, Business Administration, or other related field, or equivalent years of relevant work experience required
A minimum of three (3) years of relevant account management, claims, operational and technical or business work experience is required.
A minimum of two (2) years of relevant Provider Relations experience supporting LTSS and HCBS experience is required.
Knowledge of Medicaid, Medicare, LTSS, and HCBS and is required
Experience translating business and contractual requirements is required
Proficient in Microsoft Office tools, including Project, Word, and Excel
Advanced troubleshooting, critical thinking, and problem-solving capabilities
Proven ability to effectively interact with all levels of management within the organization
Flexibility during organizational and/or business changes
Demonstrate excellent analysis and collaboration skills
Demonstrate sense of urgency
Ability to effectively and efficiently work within a team
Exceptional written and verbal communication skills
Strong interpersonal and relationship building skills
Ability to work independently and within a team environment
Ability to multi-task and prioritize work to meet project deadlines
Critical listening and thinking skills
Time management skills
Customer service oriented
Decision making/problem solving skills
Employment in this position is conditional pending successful clearance of a driver’s license record check.
Influenza vaccination is a requirement of this position.
Reside in the state of Ohio.

Nice To Haves

Experience with Facets and other operational systems preferred
Accreditation experience preferred

Responsibilities

Own the relationship with LTSS and HCBS providers with a proactive focus on overall provider satisfaction and retention
Develop, maintain, and enhance relationships with key stakeholders including relevant provider associations.
Act as a liaison and SME to providers and operations for the LTSS/HCBS provider network
Work as community partner to assist LTSS/HCBS providers; develop education and establishing a proactive process for these providers.
Work in collaboration with Operations and other internal stakeholders on provider issues including researching providers claim issues and provide a professional and comprehensive response to providers
Work with leadership team to define deliverables and timelines
Improve Electronic Visit Verification compliance rates for provider network
Perform virtual and in-person initial onboarding and ongoing education to provider network.
Prepare and lead internal and external meetings with key stakeholders
Assist with the implementation of strategy on independent provider network
SME for Waiver services for internal and external stakeholders
Collaborate with Care Management, Incident Management and SIU to ensure providers are educated on billing practices.
Provide education to internal and external partners on LTSS and HCBS services, billing, and portal support
Responsible for understanding and educating providers on regulation changes
Collaborate with leadership to ensure initiatives are properly managed
Produce detailed reports, executive summaries, and business decision documents
Provide clarification/verification for all levels regarding status/details
May support other lines of business as needed
Perform any other job duties as requested