HR Recruiting Services · 2 months ago
Provider Engagement Account Manager
United States
Full-time
Remote
Entry, Mid Level
2+ years expRightFitRightHire is seeking a Provider Engagement Account Manager who will be responsible for cultivating and maintaining strong partnerships with contracted healthcare providers. The role focuses on enhancing provider performance, ensuring high-quality care delivery, and optimizing network efficiency through strategic account management.
EmploymentHuman ResourcesRecruiting
Responsibilities
Build and sustain effective relationships with healthcare providers and act as the main liaison between providers and the health plan
Conduct regular in-person visits to physicians and clinical staff to discuss performance metrics, identify opportunities for improvement, and support value-based care initiatives
Manage provider performance through data analysis, performance reviews, and strategic planning to meet quality, cost, and utilization goals (HEDIS, HBR, P4Q, etc.)
Triage provider issues, coordinate responses with internal teams, and ensure timely resolution
Drive provider performance improvement initiatives, including risk adjustment, quality measures, and cost/utilization management
Support special projects and perform other duties as assigned, ensuring compliance with all policies and standards
Utilize data analytics to track provider performance and deliver actionable feedback to optimize care delivery
Collaborate with providers on incentive-based models to promote value-based care and patient outcomes
Travel locally up to 4 days per week within Georgia
Qualification
Required
Bachelor's degree in healthcare, business, or related field; or equivalent experience
Minimum of two (2) years' experience in provider engagement, account management, or performance management within a managed care setting
Proven experience and proficient with provider relations, cost utilization, quality measures (HEDIS), and performance improvement
Strong project management skills in healthcare environments such as medical groups, IPAs, or health plans
Proficiency in data analysis related to healthcare quality, cost, and utilization
Excellent communication, relationship-building, and problem-solving skills
Preferred
Account management experience strongly preferred
Experience with value-based care models and incentive programs
Knowledge of managed care industry standards and compliance
Benefits
Competitive pay
Health insurance
401K and stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Company
HR Recruiting Services
HR Recruiting Services is a consultancy that provides selection process, human resource, recruiting and employment background services.
0-1 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase