Provider Relationship Account Manager Sr.

Elevance Health - Ashburn, VA

Full-time - Mid Level

Hybrid - Ashburn, VA

11-50 employees

Insurance Carriers and Related Activities

About the position

The Provider Relationship Account Manager Sr. is responsible for delivering quality service to the provider community, ensuring positive relationships and effective communication regarding administrative and programmatic changes. This role involves resolving complex provider issues, coordinating with internal partners, and participating in provider education and outreach initiatives.

Responsibilities

• Develop and maintain positive provider relationships through regular visits and communication.
• Serve as a resource expert on provider issues affecting satisfaction and network retention.
• Research and resolve complex provider issues and appeals in collaboration with internal partners.
• Coordinate Joint Operation Committees (JOC) and drive discussions on provider issues.
• Assist in Annual Provider Satisfaction Surveys and monitor corrective action plans.
• Conduct proactive outreach to educate providers on managed care policies and initiatives.
• Participate in external Provider Townhalls/Seminars and State Association conferences.
• Identify and report on provider utilization patterns impacting service delivery.
• Research issues that may affect future provider contract negotiations.
• Monitor department metrics and provide feedback on performance management.

Requirements

• Bachelor's degree required.
• Minimum of 5 years of customer service experience, including 2 years in a healthcare or provider environment.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical, dental, and vision insurance
• Short and long-term disability benefits
• 401(k) with matching
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources