Strategic Provider Partnerships Manager

Highmark Health; Wilkes-Barre (Luzerne County); Hybrid; USD 95,000 - 130,000; Full time

Job summary

Highmark Inc. is seeking a Provider Account Manager for strategic accounts to own and optimize relationships with large provider groups within the Highmark Network.

The role drives value-based reimbursement initiatives and collaborates with internal teams to improve quality and cost outcomes. You will educate providers on reimbursement changes, coordinate with contracting, operations and analytics, and maintain proactive communication to ensure success across STAR/HEDIS programs and shared

Qualifications

• Bachelor’s degree in Business, Healthcare related field.
• Knowledge of CMS, HIPAA privacy and security regulations.
• Experience presenting concepts to varying audiences.
• Strong written and oral communication skills.

Responsibilities

• Own and optimize provider relationships within the network.
• Lead value-based reimbursement activities and initiatives.
• Educate providers on reimbursement policies and new tools.
• Coordinate with contracting, operations and analytics teams.
• Communicate progress and results to senior leaders.

Skills

Provider market knowledge

Public speaking

Communication skills

Project management

Analytical skills

Education

Bachelor's degree in Business or Healthcare

Tools

PowerPoint

Excel

Word

Analytics tools

Job description

Highmark Inc. is seeking a Provider Account Manager for strategic accounts to own and optimize relationships with large provider groups within the Highmark Network.

The role drives value-based reimbursement initiatives and collaborates with internal teams to improve quality and cost outcomes. You will educate providers on reimbursement changes, coordinate with contracting, operations and analytics, and maintain proactive communication to ensure success across STAR/HEDIS programs and shared