Veracity Software Pvt. Ltd. ยท 2 months ago
Provider Engagement Account Manager
GA
Full-time
Hybrid
Entry, Mid Level
2+ years expVeracity Software Pvt. Ltd. is looking for a Provider Engagement Account Manager who will act as the key liaison between health plans and contracted provider networks. This role focuses on managing provider relationships, optimizing performance through data-driven insights, and implementing value-based care initiatives.
Information Technology & Services
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
Required
Education: Bachelor's degree in a related field or equivalent experience
Experience: Minimum 2 years of provider engagement or account management experience within a managed care organization, IPA, or health plan
Demonstrated experience in provider performance management, cost/utilization analysis, and value-based care models
Strong understanding of HEDIS/quality measures and medical loss ratio (MLR)
Excellent communication, negotiation, and relationship management skills
Proficiency with Microsoft Office tools and comfort interpreting data and performance reports
Willingness and ability to travel up to 4 days/week across Georgia
Preferred
Experience in project management within a clinical or provider network environment
Background in Population Health, Care Management, or Clinical Operations
Experience facilitating performance management conversations with providers
Strong problem-solving and analytical thinking abilities
Company
Veracity Software Pvt. Ltd.
At Veracity, if you have an idea you want to validate, a product you need to build, or an existing product that needs optimization, our teams are trained to jump in wherever needed.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase