Account Manager, Provider Relations

Overview Manages all aspects of provider relations within a specified geographic region. Regularly visits and maintains ongoing contact with existing/potential providers for relationship building, recruitment, credentialing, re‑credentialing and assisting with provider issues and education. Works under general supervision. What We Provide Referral bonus opportunities Generous paid time off (PTO), starting at 20 days and 9 company holidays Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability Employer‑matched 401k retirement saving program Personal and financial wellness programs Pre‑tax flexible spending accounts (FSAs) for healthcare and dependent care and commuter transit program Generous tuition reimbursement for qualifying degrees Opportunities for professional growth and career advancement and CEU credits What You Will Do Manage all provider contracts in designated territory, including recruitment, credentialing, re‑credentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers. Prepare materials for and orient providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination. Collaborate with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts. Monitor contract performance of network providers and serve as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues. Coordinate provider site visits, as needed. Coordinate and attend meetings to serve as a resource and address provider issues. Update and maintain provider manuals with current Health Plan policies and procedures. Update and proof provider directories. Assist providers in triaging billing and claims disputes. Participate and collaborate with Compliance on Department of Health and internal audits. Participate in special projects and perform other duties as assigned. Qualifications Licenses and Certifications: Driver's license required Education: Bachelor's Degree or equivalent related work experience, preferably in health care setting required Work Experience: Must be local to the New York City metropolitan area; Bilingual in Mandarin, Bengali or Urdu preferred; Minimum three years health care experience required; Knowledge of government programs, including Medicare and Medicaid preferred; Prior experience in Provider Relations preferred Pay Range USD $30.71 - $38.41 /Hr. #J-18808-Ljbffr VNS Health