Bright Vision Technologies · 3 days ago
Provider Network Account Manager
United States
Full-time
Remote
Entry, Mid Level
2+ years expBright Vision Technologies is a forward-thinking software development company dedicated to building innovative solutions that help businesses automate and optimize their operations. They are seeking a skilled Provider Network Account Manager to build and maintain strong partnerships between health plans and contracted provider networks, driving performance improvement across various initiatives.
Artificial Intelligence (AI)Cyber SecurityInformation TechnologySoftware
Responsibilities
Serve as the primary point of contact for assigned providers
Build strong, consultative relationships to ensure high-quality care delivery
Conduct regular in-person physician visits to provide real-time support and guidance
Perform provider orientations and ongoing education, including updating training materials
Triage and resolve provider issues in collaboration with internal teams
Investigate, resolve, and communicate provider claims issues
Initiate and maintain accurate provider demographic data updates
Educate providers on referrals, claims submission, EDI, website tools, and policies
Manage network performance using a consultative, data-driven approach
Evaluate provider performance and develop improvement strategies
Drive performance in key areas including: HEDIS / Quality Measures, Risk / Pay-for-Quality (P4Q), Medical Loss Ratio (MLR) / Health Benefit Ratio (HBR), Cost and utilization management
Support and align providers with value-based care model initiatives
Complete special projects as assigned
Travel locally up to 4 days per week
Perform other duties as required
Ensure compliance with all policies, standards, and regulations
Qualification
Required
Bachelor's degree in a related field or equivalent experience
2+ years of provider engagement or account management experience
Project management experience in a medical group, IPA, or health plan setting
Strong working knowledge of HEDIS / Quality metrics
Strong working knowledge of Cost and utilization management
Strong working knowledge of Value-based care models
Benefits
Competitive base pay
Medical, dental, and vision insurance
401(k) and employee stock purchase plans
Tuition reimbursement
Paid time off and holidays
Flexible work arrangements (field, hybrid, or office-based as applicable)
Company
Bright Vision Technologies
Bright Vision Technologies is an information technology company that offers software development, AI, and cybersecurity services.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase