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Veracity Software Inc · 2 months ago

Provider Engagement Account Manager

Georgia, United States

Full-time

Hybrid

Entry, Mid Level

2+ years exp

Veracity Software Inc is seeking a Provider Engagement Account Manager who will act as the key liaison between health plans and provider networks. This role focuses on managing provider relationships, optimizing performance metrics, and enhancing patient care delivery through collaboration and data-driven strategies.

Information TechnologySaaSSoftwareTechnical SupportWeb Development

Growth Opportunities

Responsibilities

Serve as the primary contact for network providers, maintaining strong partnerships and acting as liaison with internal teams

Conduct regular provider visits to discuss performance metrics, quality measures, and improvement strategies

Manage provider performance using data-driven insights to enhance cost efficiency, quality, and patient outcomes

Develop and execute strategic performance improvement plans to address risk, P4Q, HEDIS, and Health Benefit Ratio (HBR) metrics

Coordinate issue resolution and escalation between providers and health plan departments

Support the implementation of value-based care initiatives and provider incentive programs

Utilize analytics to monitor contract performance, cost utilization, and quality outcomes

Participate in special projects and cross-functional initiatives as assigned

Travel locally within the assigned Georgia territory (up to 4 days/week)

Qualification

Provider performance managementValue-based care modelsCost/utilization analysisHEDIS/quality measuresData analyticsMicrosoft Office proficiencyRelationship managementAnalytical thinkingCommunication skillsNegotiation skillsProblem-solving abilities