Commonwealth Care Alliance · 1 week ago
Provider Relations Account Manager - R11598
Commonwealth Care Alliance is a nonprofit health plan and care delivery organization focused on individuals with significant needs. The Provider Relations Account Manager is responsible for managing relationships with health partners/providers, ensuring satisfaction and retention, and driving operational improvements within the organization.
Health CareHospitalMedical
Responsibilities
Own the relationship with the Health Partner/Provider with a proactive focus on overall provider satisfaction and retention
Identify, solution, and execute on Health Partner/Provider escalations and systemic opportunities (including complex and/or non routine) for continuous operational improvement
Prepare and lead internal and external meetings with key stakeholders
Assure department deliverables are met with timely follow up
Educate health partners/providers on, all operational updates
Analyze current work processes, identify gaps and implement appropriate correction
Responsible for maintaining strong internal relationships with key business partners
Perform quality assurance reviews to ensure that provider information is loaded correctly and contracting terms are accurately operationalized
Perform provider outreach, field visits and site evaluations to ensure compliance with the provider contract, and state and federal requirements
Develop and utilize key operational dashboards with providers
Manage multiple projects, collect and analyze data and disseminate to appropriate departments as necessary
Ensure appropriate documentation of interactions and projects
Support Leadership in meeting annual goals
Perform any other job duties as requested
Qualification
Required
Bachelor's Degree in Business Administration, or related field or equivalent years of relevant work experience is preferred
A minimum of three (3) years of experience in the health plan/managed care industry is required
Proficient with Microsoft Office to include Word, Excel and PowerPoint
Excellent written and verbal communications skills
Ability to develop, prioritize and accomplish goals
Detail oriented
Strong interpersonal skills and high level of professionalism
Effective listening and critical thinking skills
Effective problem-solving skills with attention to detail
Ability to work independently and within a team
Strong negotiation skills
Excellent leadership skills
Exceptional emotional intelligence
Ability to create and maintain excellent working relationships
Project management
Conflict resolution
Facilitation management
Analytical skills
Employment in this position is conditional pending successful clearance of a driver's license record check
To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position
Mobile Worker: This is a mobile position, meaning that regular travel to different work locations is essential
May be required to travel greater than 50% of time to perform work duties
A valid driver's license, car, and insurance are necessary for work related travel
Preferred
Experience in a managed care organization is preferred
Benefits
In addition to base compensation, you may qualify for a bonus tied to company and individual performance.
We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Company
Commonwealth Care Alliance
Commonwealth Care Alliance is an integrated care system that advocates for economical healthcare policies.
Funding
Current Stage
Late StageTotal Funding
$1.77MKey Investors
The Robert Wood Johnson Foundation
2025-04-09Acquired
2019-11-11Grant· $1.77M
Leadership Team
Recent News
2025-12-29
Press Telegram
2025-12-03
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