Hospital Relations, Health Plan Account Manager
2 months ago
Hospital Relations, Health Plan Account Manager
Manhattan, New York Provider RelationsApply Now Job ID R010681 Overview
Manages all aspects of provider relations within a specified geographic region. Regularly visits and maintains ongoing contact with existing/potential providers for relationship building, recruitment, credentialing, re-credentialing and assisting with provider issues and education. Works under general supervision.
Compensation:
$30.71 - $38.41 Hourly
What We Provide
Referral bonus opportunities Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability Employer-matched retirement saving funds Personal and financial wellness programs Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care Generous tuition reimbursement for qualifying degrees Opportunities for professional growth and career advancement Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunitiesWhat You Will Do
Manages all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers. Prepares materials for and orient providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination. Collaborates with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts. Monitors contract performance of network providers and serves as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues. Coordinates provider site visits, as needed. Coordinates and attends meetings to serve as a resource and addresses provider issues. Updates and maintains provider manuals with current Health Plan policies and procedures. Updates and proofs provider directories. Assists providers in triaging billing and claims disputes. Participates and collaborates with Compliance on Department of Health and internal audits. Participates in special projects and performs other duties as assigned.Qualifications
Licenses and Certifications:
Driver's license, required
Education:
Work Experience:
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