Provider Relations Account Manager

CareSource Management Services LLC; Mobile (AL); On-site; USD 72,000 - 116,000; Full time

Job summary

CareSource/Commonwealth Care Alliance in Mobile, AL is seeking a Provider Relations Account Manager to influence stakeholder relationships in a highly matrixed organization. You will own provider partnerships, focus on satisfaction and retention, and drive operational efficiencies through proactive engagement and escalation management.

You will lead meetings with providers and internal teams, analyze processes, ensure contract compliance, and leverage dashboards to monitor performance.

Qualifications

• Bachelor's degree in Business Administration or related field preferred.
• Three (3) years of experience in the health plan/managed care industry required.
• Experience in a managed care organization preferred.

Responsibilities

• Own the relationship with Health Partner/Provider with a proactive focus on overall provider satisfaction and retention.
• Identify, solution, and execute on escalations and systemic opportunities for continuous operational improvement.
• Prepare and lead internal and external meetings with key stakeholders.
• Assure department deliverables are met with timely follow up.
• Educate health partners/providers on all operational updates.
• Analyze current work processes, identify gaps and implement corrections.
• Maintain strong internal relationships with key business partners.
• Perform provider outreach, field visits and site evaluations for contract/state/federal compliance.
• Utilize dashboards with providers and manage multiple projects.

Skills

Provider relations

Stakeholder management

Communication

Project management

Analytical skills

Microsoft Office (Word, Excel, PowerP)

Negotiation

Leadership

Emotional intelligence

Education coordination

Education

Bachelor's degree in Business Administration

Job description

Job Summary

The Provider Relations Account Manager at CareSource/Commonwealth Care Alliance is responsible for working in a highly matrixed organization and influencing internal stakeholder relationships. This role will engage with providers to build, manage and maintain relationships, with a strong focus on operational efficiencies, proactive engagement, and reduced burden which all leads to retention of provider relationships.

Essential Functions

• Own the relationship with the Health Partner/Provider with a proactive focus on overall provider satisfaction and retention
• Identify, solution, and execute on Health Partner/Provider escalations and systemic opportunities (including complex and/or non-routine) for continuous operational improvement
• Prepare and lead internal and external meetings with key stakeholders
• Assure department deliverables are met with timely follow up
• Educate health partners/providers on, all operational updates
• Analyze current work processes, identify gaps and implement appropriate correction
• Responsible for maintaining strong internal relationships with key business partners
• Perform provider outreach, field visits and site evaluations to ensure compliance with the provider contract, and state and federal requirements
• Utilize and leverage key operational dashboards with providers
• Manage multiple projects, collect and analyze data and disseminate to appropriate departments as necessary
• Ensure appropriate documentation of interactions and projects
• Support Leadership in meeting annual goals
• Performs any other job related duties as requested.

Education and Experience

Bachelor's degree in Business Administration, or related field preferred. Equivalent years of relevant work experience may be accepted in lieu of required education. Three (3) years of experience in the health plan/managed care industry required. Experience in a managed care organization preferred.

Competencies, Knowledge and Skills

• Proficient with Microsoft Office to include Word, Excel and PowerPoint
• Excellent written and verbal communications skills
• Ability to develop, prioritize and accomplish goals
• Detail oriented
• Strong interpersonal skills and high level of professionalism
• Effective listening and critical thinking skills
• Effective problem-solving skills with attention to detail
• Ability to work independently and within a team
• Strong negotiation skills
• Excellent leadership skills
• Exceptional emotional intelligence
• Ability to create and maintain excellent working relationships
• Project management
• Conflict resolution
• Facilitation management
• Analytical skills

Licensure and Certification

• Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated.

Health and Vaccination Requirements

To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified. CareSource adheres to all federal, state, and local regulations.

Accommodation and Disability

CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.

Working Conditions

• This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential.
• Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time.
• Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need.
• May be required to travel greater than 50% of time to perform work duties.
• Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer.
• Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members.
• Over 50% (Mobile).
• Routine travel required.

Compensation Range

$72,200.00 - $115,500.00. CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type

Salary.

Organization Level Competencies

• Fostering a Collaborative Workplace Culture
• Cultivate Partnerships
• Develop Self and Others
• Drive Execution
• Influence Others
• Pursue Personal Excellence
• Understand the Business

Disclaimer

This job description is not all inclusive.

Equal Opportunity Statement

CareSource is an Equal Opportunity Employer.

We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Brand and Mission

#LI-AB1 Brand=Commonwealth Care Alliance

The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.