Provider Relationship Account Mgr (US)

Elevance Health•Los Angeles, CA

1d•$77,556 - $96,945•Remote

About The Position

The Provider Relationship Account Manager (US) will be responsible for providing quality, accessible and comprehensive service to the company's provider community. This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Requirements

Requires a bachelor’s degree
minimum of 3 years of customer service experience
2 years of experience in a healthcare or provider environment
Travels to worksite and other locations as necessary

Responsibilities

Develop and maintain positive provider relationships with the provider community by regular on-site and/or virtual/digital visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.
Serve as a knowledge and resource expert regarding provider issues impacting provider satisfaction and network retention; research, analyze, and coordinate prompt resolution 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.
Be assigned to a portfolio of providers within a defined cohort.
Coordinate Joint Operation Committees (JOC) of provider groups, driving the meetings in the discussion of issues and changes.
Assist Annual Provider Satisfaction Surveys, required corrective action plan implementation and monitoring education, contract questions and non-routine claim issues.
Coordinate communications process on such issues as 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 on a variety of 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 which have a direct impact on the quality-of-service delivery.
Research issues that may impact future provider contract negotiations or jeopardize network retention.