Provider Relationship Account Manager - New Hampshire

Provider Relationship Account Manager - New Hampshire

Provider Relationship Account Manager (New Hampshire) JR168320

Location : Hybrid 1. This role requires associates to be in our Manchester, NH office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

The Provider Relationship Account Manager is responsible for providing quality, accessible and comprehensive service to the company's provider community.

• Develops and maintains positive provider relationships with the provider community by regular on-site and / or virtual / digital visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.
• Serves as a knowledge and resource expert regarding provider issues impacting provider satisfaction and network retention; researches, analyzes, and coordinates prompt resolution to complex provider issues and appeals through direct contact with providers and internal matrixed partners.
• Collaborates within a cohort of internal matrix partners to triage issues and submit work requests.
• Supports an assigned portfolio of providers (hospitals, professional, ambulatory, ancillaries, FQHC's, etc).
• Coordinates Joint Operation Committees (JOC) of provider groups, driving the meetings in the discussion of issues and changes.
• Assists with Annual Provider Satisfaction Surveys, required corrective action plan implementation and monitoring education, contract questions and non-routine claim issues.
• Coordinates communications process on such issues as administrative and medical policy, reimbursement, and provider utilization patterns.
• Conducts proactive outreach to support the understanding of managed care policies and procedures, as well as on a variety of initiatives and programs.
• Participates in external Provider Townhalls / Seminars and attends State Association conferences (e.g. : MGMA, AFP, AAP, HFMA).
• Identifies and reports on provider utilization patterns which have a direct impact on the quality-of-service delivery.
• Researches issues that may impact future provider contract negotiations or jeopardize network retention.

Minimum Requirements :

Preferred Skills, Capabilities and Experiences :

Job Level : Non-Management Exempt

Job Family : PND >

Provider Relationship Account Mgmt

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.