Provider Network Account Manager II

Provider Network Account Manager II

Manage provider contracting and relationship processes, including drafting, negotiating, and implementing contracts. Handle accounts that include large provider organizations and individual practitioners. Ensure compliance with regulatory requirements and maintain network adequacy. Provide orientation and educational visits to providers regarding practices and policies. Oversee contract implementations and renegotiation functions. Facilitate communication between providers and internal departments to resolve issues. Support credentialing processes and investigate member complaints.

Develop and maintain positive working relationships with providers. Monitor network adequacy and ensure access to services. Conduct provider training and maintain provider credentials. Negotiate contract terms and ensure adherence to requirements. Serve as a liaison between providers and internal departments.

Bachelor's Degree or equivalent education/experience. 3-5 years of experience in contracting and/or regulatory analysis in managed care or healthcare. 3 years of healthcare experience in Managed Care or related settings. Strong organizational and communication skills. Knowledge of financial analysis and computer skills, including MS Office.