Medicaid Provider Relationship Account Manager-Hybrid to Indianapolis

Professional Management Enterprises•Indianapolis, IN

6d•Hybrid

About The Position

BKG Enterprises is seeking a Medicaid Provider Relationship Account Manager responsible for providing quality, accessible, and comprehensive service to the company's provider community. The role involves developing and maintaining positive provider relationships through regular on-site and/or virtual visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.

Requirements

Requires a Bachelor’s degree.
Minimum of 3 years of customer service experience, including 2 years in a healthcare or provider environment.
Or any combination of education and experience which provides an equivalent background.
Excellent oral, written, and interpersonal communication skills.
Strong problem-solving, facilitation, and analytical skills.
Ability to travel as required.

Responsibilities

Develop and maintain positive relationships with the provider community by conducting regular on-site and/or virtual/digital visits.
Communicate administrative and programmatic changes to providers.
Facilitate education and resolve provider issues promptly.
Serve as a knowledge and resource expert regarding provider issues impacting provider satisfaction and network retention.
Research, analyze, and coordinate prompt resolutions to complex provider issues and appeals through direct contact with providers and internal matrixed partners.
Collaborate within a cohort of internal matrix partners to triage issues and submit work requests.
Manage a portfolio of providers within a defined cohort.
Coordinate Joint Operation Committees (JOC) with provider groups, driving meetings to discuss issues and changes.
Assist with Annual Provider Satisfaction Surveys, implement required corrective action plans, and monitor educational activities, contract questions, and non-routine claim issues.
Coordinate communications on administrative and medical policy, reimbursement, and provider utilization patterns.
Conduct proactive outreach to support the understanding of managed care policies and procedures, as well as various initiatives and programs.
Participate in external Provider Townhalls/Seminars and attend State Association conferences (e.g., MGMA, AFP, AAP, HFMA).
Identify and report on provider utilization patterns that impact the quality of service delivery.
Research issues that may impact future provider contract negotiations or jeopardize network retention.