Provider Account Manager

Q Point Health LLC•Scottsdale, AZ

21h•Remote

About The Position

Equality Health is an integrated, holistic, and tech-enabled healthcare delivery system focused on improving the health and wellness of diverse populations. Founded in 2015, Equality Health aims to improve access to value-based care for people who have long struggled with navigating the traditional one-size-fits-all U.S. healthcare system. The mission of the company is to provide high-quality care that improves and enhances lives regardless of race, ethnicity, age, or income. Through its supplemental care management services and proprietary technology platform, CareEmpower™, Equality Health helps managed care plans and health systems improve outcomes and lower costs for diverse populations while simultaneously facilitating the transition to risk-based accountability. Equality Health supports over 800,000 members and more than 4,000 practice sites and continues to scale rapidly. In 2021, Equality Health partnered with General Atlantic, a leading global growth equity firm, to help drive continued expansion and fuel the next phase of growth as a leading value-based primary care network serving the Medicaid, Medicare and ACA Exchange populations. This strategic investment will enable Equality Health to pursue further geographic expansion, technological innovation and product development while furthering its mission of increasing access to care, lowering costs and improving outcomes for underserved individuals, families and communities. The Provider Account Manager (PAM) is an Arizona market-based position and is responsible for Recruitment & Contracting; Account relationship management/retention; and Performance Management of providers/practices with less than 2000 members.

Requirements

Bachelor’s degree in Business, Healthcare Administration or a related field of study; or an equivalent combination of education and/or experience
Minimum four (4) years of experience in healthcare; network development, account management or other related positions
Experience working with providers through an ownership model, partner arrangement or other affiliation.
Travel by personal automobile to multiple community locations. Up to 25% local travel throughout Arizona.
Communication (verbal and written) - Demonstrated ability to communicate with customers in a clear, persuasive, and professional manner; experienced in delivering customer facing presentations that resonates with the customer while demonstrates company’s value add. Able to convey complex or technical information in a manner that others can understand.
Relationship Management – Client focused and empathetic, ability to influence key stakeholders, facilitate conflict resolution
Problem Solving – Ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action.
Collaborative – Highly collaborative individual with the ability to work effectively across a matrixed organization to deliver on customer expectations and resolve issues.
Proficiency with MS Office applications and web-based technologies

Nice To Haves

Demonstrated understanding of risk and value-based contracting
Experience with sales initiatives, provider research and market analysis
Familiar with conventional payment methodologies (CMS-RBRVS)
Familiar with payment alternatives such as fee for service, capitation, global budget, performance compensation and episode of care payment
Familiar with patient and practice risk adjustment mechanics and premium-based payment methodologies
Familiar with patient and practice risk adjustment mechanics, APR; HCC/RAF
Experience with CRM platforms/tools

Responsibilities

Lead generation and recruitment and finalize contracting and enrollment process
Develop and present business value proposition to practices to include physicians, practice staff, and other key stakeholders as needed.
Pipeline management to move provider practices/hospitals/clinics to execution
Prospect new providers for recruitment/growth
Conduct local market research to ensure strong understanding of market needs and identification of prospects
Secure provider signatures to enroll practices and ensure completion of all onboarding documentation.
Manage payer addendum opportunities to drive membership density among Equality Health Network participating practices
Participate and actively engage in provider/community events
Achieves market growth goals
Maintain CRM (Salesforce) account information and activities of assigned practice groups: practice profile, key practice contacts, document meeting events & communication, etc.
Serve as primary contact and relationship manager for ongoing communication with all assigned accounts, ensuring trust, engagement, and customer satisfaction
Welcome and onboard new practice group(s) into the EQH network & model: EQH welcome presentation, practice transformation training, and support expectations
Schedule, lead, and manage recurring business and clinical operational touchpoints
Monitor provider usage of Care Empower and provide ongoing coaching of proper usage of Care Empower (Worklists, Chart Prep Tool, etc.)
Facilitate support for initial and supplemental training with appropriate centralized teams for the following: CareEmpower (CE), ECIP incentive program
Management of roster reconciliation, opt-ins and renewals
Manage provider documentation requests from payer.
Review, address and process terminations from practices as needed
Triage, address, and resolve provider inquiries and concerns promptly to sustain positive partnerships
Lead and manage overall program performance for providers with less than 2,000 lives (Established Markets) and less than 1,000 lives (Emerging Markets)
Facilitating CE usage and troubleshooting (e.g. worklist management and associated patient scheduling, leveraging Chart Prep Tool, etc.)
Establish practice group’s weekly, monthly operational goals to achieve annual performance goals in Access to Care, Wellness, TOC and HRM (from Care Signals)
Evaluate practice progress and performance against goals
Identify practice barriers and support practice with recommendations to overcome barriers to performance
Consult with practices to review ECIP performance, opportunities, and actions that fully optimize incentive opportunity
Address issues, concerns, feedback from practices on ECIP program, including ECIP payment and data validation.
Deliver practice performance reports: Quality, TOC, HRM
Deliver practice ECIP payment dashboards and member detail reports
Respond to requests for ad hoc reporting needs to support the practice