Provider Relations Account Manager

CareSource

3d • $72,200 - $115,500 • Onsite

About The Position

The Provider Relations Account Manager at CareSource/Commonwealth Care Alliance works in a highly matrixed organization and influences internal stakeholder relationships. The role engages providers to build, manage, and maintain relationships, focusing on operational efficiency, proactive engagement, reducing provider burden, and retaining provider relationships.

The position owns provider relationships and provider satisfaction, addresses escalations and opportunities for operational improvement, leads meetings, educates providers on operational updates, and coordinates projects and department deliverables. It also conducts provider outreach, field visits, and site evaluations to support compliance with provider contracts and state and federal requirements. The role is mobile and requires regular travel to assigned work locations, potentially more than 50% of the time. Flexible hours, including possible evenings and weekends, may be needed to serve members.

Requirements

• Three years of experience in the health plan or managed care industry.
• Proficiency with Microsoft Office, including Word, Excel, and PowerPoint.
• Excellent written and verbal communication skills.
• Ability to develop, prioritize, and accomplish goals.
• Detail-oriented approach.
• Strong interpersonal skills and a high level of professionalism.
• Effective listening and critical-thinking skills.
• Effective problem-solving skills with attention to detail.
• Ability to work independently and as part of a team.
• Strong negotiation skills.
• Excellent leadership skills and exceptional emotional intelligence.
• Ability to create and maintain excellent working relationships.
• Project management, conflict resolution, facilitation management, and analytical skills.
• Valid driver's license, vehicle, and verifiable insurance; employment is conditional on an acceptable driver's license record check.
• Annual influenza vaccination is required for designated positions during influenza season (October 1–March 31); employees hired during that season have 30 days from hire to complete the vaccination and verify immunization.
• Must reside in the assigned territory, although exceptions may be considered based on business need.
• Ability to travel regularly, potentially more than 50% of the time, and work flexible hours, including possible evenings or weekends as needed.

Nice To Haves

• Bachelor's degree in Business Administration or a related field; equivalent years of relevant work experience may be accepted in lieu of required education.
• Experience in a managed care organization.

Responsibilities

• Own relationships with health partners/providers, proactively focusing on provider satisfaction and retention.
• Identify, develop solutions for, and execute on health partner/provider escalations and systemic opportunities for continuous operational improvement, including complex or non-routine issues.
• Prepare and lead internal and external meetings with key stakeholders.
• Ensure department deliverables are met through timely follow-up.
• Educate health partners/providers about operational updates.
• Analyze current work processes, identify gaps, and implement appropriate corrections.
• Maintain strong relationships with key internal business partners.
• Conduct provider outreach, field visits, and site evaluations to support compliance with provider contracts and state and federal requirements.
• Use and leverage key operational dashboards with providers.
• Manage multiple projects, collect and analyze data, and share information with appropriate departments as needed.
• Ensure appropriate documentation of interactions and projects.
• Support leadership in meeting annual goals.
• Perform other job-related duties as requested.

Benefits

• May qualify for a bonus tied to company and individual performance.
• Substantial and comprehensive total rewards package focused on employee well-being.
• Reasonable accommodations are available to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level