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Peach State Health Plan · 1 day ago

Provider Engagement Account Manager

Georgia, United States

Full-time

Hybrid

Entry, Mid Level

$56K/yr - $101K/yr

2+ years exp

Peach State Health Plan is transforming the health of communities and seeking a Provider Engagement Account Manager. The role involves maintaining partnerships with provider networks, driving performance improvements, and managing client relations to ensure high-quality care for members.

Health Care

Responsibilities

Serve as primary contact for providers and act as a liaison between the providers and the health plan

Triages provider issues as needed and coordinates response with internal matrix partners

Receive and effectively respond to external provider related issues

Manages provider performance for assigned territory through a consultative/ account management approach

Evaluates provider performance and develops strategic plan to improve performance

Drives provider performance improvement in the following areas Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc

Completes special projects as assigned

Ability to travel locally 4 days a week

Performs other duties as assigned

Complies with all policies and standards

Conducts regular in-person visits with physicians to provide real-time support, discuss performance metrics, and identify opportunities for improvement in patient care and clinical practices

Focuses on value-based care model initiatives, collaborating with physicians to identify and align to performance-based agreements that incentivize better patient outcomes, cost-efficiency, and quality care

Uses data analytics to track and monitor provider performance, offering actionable feedback to help physicians optimize care delivery and meet key performance targets

Qualification

Provider engagementAccount managementData analyticsHEDIS/Quality measuresValue-based careProject managementCommunication skillsProblem-solving skills

Required

Bachelor's degree in related field or equivalent experience

Two years of provider engagement account management experience

Project management experience at a medical group, IPA, or health plan setting

Proficient in HEDIS/Quality measures, cost (MLR) and utilization

Ability to travel locally 4 days a week

Benefits

Health insurance

401K

Stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Company

Peach State Health Plan

Peach State Health Plan is a Care Management Organization that provides health care services through its provider network. It is a sub-organization of Centene.

Founded in 2006

Atlanta, Georgia, USA

201-500 employees