LTSS Provider Relations Account Manager

CareSource-posted 5 months ago

$81,400 - $130,200/Yr

Full-time

Mobile, AL

1,001-5,000 employees

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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.

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.

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 is required.
Experience translating business and contractual requirements is required.
Experience with Facets and other operational systems preferred.
Accreditation experience preferred.

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.

Compensation range of $81,400.00 - $130,200.00.
Bonus tied to company and individual performance.
Comprehensive total rewards package.
Flexible hours, including possible evenings and/or weekends as needed.

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