Provider Engagement Account Specialist
2 weeks ago
Provider Engagement Account Specialist
Job Overview:
The Provider Engagement Account Specialist plays a crucial role in delivering exceptional service to our provider network. This position is designed for individuals who thrive in a collaborative environment and are dedicated to enhancing provider relationships through effective communication and support.
Key Responsibilities:
- Establish and nurture strong relationships with providers through various communication channels, including email, phone, and in-person meetings, ensuring they are informed about administrative and programmatic updates.
- Work closely with internal teams to address provider concerns and facilitate the resolution of issues efficiently.
- Manage a designated portfolio of providers, conducting thorough research and analysis to resolve inquiries and appeals in a timely manner.
- Oversee the communication process regarding administrative policies, reimbursement procedures, and provider utilization trends.
- Conduct regular outreach to educate providers on managed care policies and initiatives, ensuring they are well-informed and supported.
- Coordinate and deliver training sessions for providers, creating and distributing educational materials to enhance their understanding of our services.
- Assist in the execution of Annual Provider Satisfaction Surveys and monitor the implementation of corrective action plans as needed.
- Support the maintenance and updates of the Provider Manual to ensure accuracy and relevance.
- Analyze provider utilization patterns to identify opportunities for improving service delivery quality.
- Investigate potential issues that may affect future provider contract negotiations or network retention strategies.
- A bachelor's degree is required, along with a minimum of 2 years of customer service experience, including at least 1 year in a healthcare or provider-focused setting.
- Familiarity with Provider Claims is advantageous.
- Experience with Medicare, Medicaid, and Marketplace Care is preferred.
- Willingness to travel as necessary for work-related duties.
Non-Management Exempt
Work Environment:
This role operates within a hybrid work model, combining remote and in-office responsibilities.
About Elevance Health:
Elevance Health is committed to enhancing the health and well-being of our communities. As a leading health organization, we seek individuals who are passionate about making a positive impact in the lives of our members. We foster a culture of growth and development, ensuring our associates thrive both personally and professionally.
We offer competitive total rewards, including merit increases, paid time off, comprehensive health benefits, retirement plans, and wellness programs, among others. Elevance Health is an Equal Employment Opportunity employer, welcoming applicants from diverse backgrounds.
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