Provider Engagement Account Manager

Fidelis Care - New York; New York (NY); On-site; USD 55,000 - 99,000; Full time

Job summary

Fidelis Care - New York is seeking a Provider Engagement Account Manager to maintain relationships and ensure the delivery of high-quality patient care. The role involves engaging with providers, analyzing performance data, and developing strategies for improvement. Candidates must have a bachelor’s degree and relevant experience, along with strong account management and analytical skills. Competitive benefits and opportunities for flexibility are offered.

Benefits

Flexible work schedules

Comprehensive benefits package

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Qualifications

• Two years of managed care or medical group experience.
• Proficient in HEDIS/Quality measures.

Responsibilities

• Maintain partnerships between the health plan and contracted provider networks.
• Conduct regular in-person visits with physicians to provide support and discuss performance metrics.
• Drive provider performance improvement in key quality metrics.

Skills

Data Analytics

Account Management

Communication

Education

Bachelor’s degree in related field

Job description

Join to apply for the Provider Engagement Account Manager role at Fidelis Care - New York

1 week ago Be among the first 25 applicants

Join to apply for the Provider Engagement Account Manager role at Fidelis Care - New York

Get AI-powered advice on this job and more exclusive features.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery of the highest level of care to our members. Engage with providers to align on network performance opportunities and solutions, and consultative account management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization.

• Conducts regular in-person visits with physicians to provide real-time support, discuss performance metrics, and identify opportunities for improvement in patient care and clinical practices
• Focuses on value-based care model initiatives, collaborating with physicians to identify and align to performance-based agreements that incentivize better patient outcomes, cost-efficiency, and quality care
• Uses data analytics to track and monitor provider performance, offering actionable feedback to help physicians optimize care delivery and meet key performance targets
• Receive and effectively respond to external provider related issues
• Investigate, resolve and communicate provider claim issues and changes
• Initiate data entry of provider-related demographic information changes
• Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics
• Perform provider orientations and ongoing provider education, including writing and updating orientation materials
• Manages Network performance for assigned territory through a consultative/account management approach
• Evaluates provider performance and develops strategic plan to improve performance
• Drives provider performance improvement in the following areas Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc.
• Completes special projects as assigned
• Ability to travel locally 4 days a week
• Performs other duties as assigned
• Complies with all policies and standards
  
  

Education/Experience Bachelor’s degree in related field or equivalent experience.

Two years of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management, or clinical operations.

Project management experience at a medical group, IPA, or health plan setting.

Proficient in HEDIS/Quality measures, cost and utilization.Pay Range $55,100.00 - $99,000.00 per year

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Sales and Business Development

• Industries

  Hospitals and Health Care and Insurance

Referrals increase your chances of interviewing at Fidelis Care - New York by 2x

Get notified about new Account Manager jobs in Bronx, NY.

New York, NY $50,000.00-$50,000.00 2 weeks ago

New York, NY $90,000.00-$135,000.00 2 weeks ago

Regional Account Manager, LinkedIn Sales Solutions

New York, NY $151,000.00-$230,000.00 1 day ago

New York, NY $60,000.00-$80,000.00 1 week ago

New York, NY $80,000.00-$90,000.00 1 day ago

New York City Metropolitan Area $70,000.00-$80,000.00 2 weeks ago

Manhattan, NY $60,000.00-$75,000.00 3 weeks ago

Elmsford, NY $110,000.00-$130,000.00 1 day ago

New York, NY $56,000.00-$108,800.00 2 weeks ago

New York City Metropolitan Area 4 days ago

New York, NY $70,000.00-$120,000.00 3 days ago

New York City Metropolitan Area $70,000.00-$80,000.00 3 weeks ago

New York, NY $75,000.00-$87,000.00 14 hours ago

National Account Manager, Non-Commercial

New York, NY $76,000.00-$133,000.00 20 hours ago

Manager, Key Accounts - Ulta (Manager, Key Accounts - Ulta (Luxe Fragrance Brands)

Account Manager, Healthcare and Community Partnerships

New York, NY $60,800.00-$76,000.00 1 week ago

New York, NY $85,000.00-$105,000.00 2 days ago

New York, NY $69,500.00-$77,000.00 2 hours ago

New York, NY $162,000.00-$246,000.00 2 days ago

New York, NY $62,000.00-$65,000.00 2 weeks ago

Account Executive, Field Sales & Training - Northeast (ULTA)

New York, NY $70,000.00-$85,000.00 1 month ago

New York, NY $129,000.00-$187,000.00 1 week ago

New York, NY $110,000.00-$160,000.00 1 week ago

New York, NY $103,000.00-$148,000.00 1 week ago

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.