Elevance Health
posted 23 days ago
Full-time - Mid Level
Onsite
11-50 employees
Insurance Carriers and Related Activities
About the position
The Provider Relationship Account Manager is responsible for delivering quality service to the provider community in the southwest region of Georgia. This role involves developing and maintaining positive relationships with providers, addressing their issues, and ensuring satisfaction and retention within the network. The position requires significant travel within the region and includes both fieldwork and remote responsibilities.
Responsibilities
- Develop and maintain positive provider relationships through on-site and virtual visits.
- Communicate administrative and programmatic changes to providers.
- Facilitate education and resolution of provider issues.
- Serve as a resource expert on provider satisfaction and network retention.
- Research and coordinate resolution of complex provider issues and appeals.
- Collaborate with internal partners to triage issues and submit work requests.
- Coordinate Joint Operation Committees (JOC) of provider groups.
- Assist with Annual Provider Satisfaction Surveys and corrective action plans.
- Coordinate communications regarding administrative and medical policy, reimbursement, and utilization patterns.
- Conduct proactive outreach to support understanding of managed care policies.
- Participate in external Provider Townhalls/Seminars and State Association conferences.
- Identify and report on provider utilization patterns affecting service delivery.
- Research issues impacting future provider contract negotiations.
Requirements
- Bachelor's degree required.
- Minimum of 3 years of customer service experience, including 2 years in a healthcare or provider environment.
- Ability to create and maintain excellent working relationships.
- Strong interpersonal skills and professionalism.
- Robust problem-solving and critical thinking skills.
- Attention to detail is essential.
- Ability to work independently and within a team.
- Proficiency with Microsoft Office (Outlook, Excel, PowerPoint).
Nice-to-haves
- Previous experience working directly with providers is strongly preferred.
Benefits
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short and long term disability benefits
- 401(k) with matching
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
