Hybrid Healthcare Provider Network Account Executive

Enlightened; Washington (District of Columbia); Hybrid; USD 72,000 - 98,000; Full time

Benefits offered by this job

Medical/Dental/Vision Insurance with H

Job summary

Enlightened in Washington, DC is seeking a Provider Network Account Executive (Onsite) to build and maintain relationships with healthcare providers across the contracted network. This hybrid role requires engaging with PCPs, specialists, FQHCs, and other providers to improve performance, engagement, and satisfaction while coordinating with internal teams.

The position supports network development, education, contract management, and issue resolution.

Qualifications

• Bachelor's degree preferred.
• 1+ years of experience as an Account Executive, Provider Relations Representative, Provider Network Specialist, or in a related healthcare provider relations role.
• Experience working with healthcare providers, managed care organizations, health plans, or provider networks preferred.
• Strong verbal and written communication skills with the ability to facilitate provider education, onboarding, presentations, and training sessions for both small and large audiences.
• Demonstrated ability to build collaborative relationships with providers and internal stakeholders.
• Strong organizational, analytical, and problem-solving skills.
• Proficiency using Microsoft Office and provider management systems is preferred.

Responsibilities

• Support provider network development and network management strategies.
• Assist leadership with initiatives related to provider satisfaction, education, engagement, and communication.
• Support the organization's Single Case Agreement (SCA) strategy.
• Build, cultivate, and maintain strong relationships with contracted providers and provider organizations.
• Resolve provider concerns and disputes in a timely, professional, and compliant manner.
• Manage an assigned portfolio of provider accounts, including individual practices, multi-site practices, integrated delivery systems, and other healthcare organizations.
• Analyze provider performance data and implement strategies to strengthen provider relationships and improve outcomes.
• Conduct provider office visits and site visits as needed.
• Maintain a working knowledge of provider databases and communicate updates related to provider additions, terminations, and demographic changes.
• Collaborate effectively with internal departments including Claims, Provider Data Management, Credentialing, Payment Integrity, Contracting, Appeals, and other operational teams.
• Develop a strong understanding of provider contracts, performance expectations, and operational processes.
• Deliver provider orientation sessions, educational presentations, and ongoing training to support provider success.
• Recruit providers to address identified network adequacy gaps.
• Support provider contracting activities across multiple product lines, including LTSS, Exchange Plans, D-SNP, and FFS agreements.
• Support Value-Based Care (VBC) provider relationships and contract negotiations, as needed.

Skills

Provider relations

Healthcare knowledge

Communication skills

Relationship management

Education

Bachelor's degree

Tools

Microsoft Office

Provider management systems

Job description

Enlightened in Washington, DC is seeking a Provider Network Account Executive (Onsite) to build and maintain relationships with healthcare providers across the contracted network. This hybrid role requires engaging with PCPs, specialists, FQHCs, and other providers to improve performance, engagement, and satisfaction while coordinating with internal teams.

The position supports network development, education, contract management, and issue resolution.