Provider Engagement Account Manager (Remote - GA Based)

We are seeking a consultative Provider Engagement Account Manager to join a leading national health plan. This role is responsible for maintaining strategic partnerships with contracted provider networks and driving optimal network performance through a consultative account management approach. The successful candidate will be accountable for improving contract incentives quality outcomes and cost utilization.

Essential Duties & Responsibilities:

Direct Provider Engagement: Conduct regular in-person visits with physicians to provide real-time support discuss performance metrics and identify opportunities for improvement in patient care.

Relationship Management: Serve as the primary contact for providers and act as a liaison between the providers and the health plan. Receive and effectively respond to external provider-related issues triaging them with internal partners as needed.

Performance Improvement: Evaluate provider performance and develop strategic plans to improve performance in key areas including: Risk/P4Q Health Benefit Ratio (HBR) HEDIS/quality and cost utilization.

Value-Based Care: Focus on value-based care model initiatives collaborating with physicians to align with performance-based agreements.

Compliance: Ensure compliance with all policies and standards

Qualifications :

Education & Experience (Required):

• Bachelors degree in a related field or equivalent experience.

• Minimum of two (2) years of provider engagement or account management experience at a medical group IPA or health plan setting.

• Project management experience is highly preferred.

Key Skills & Competencies:

• Proficient in HEDIS/Quality measures cost (MLR) and utilization metrics.

   

• Strong interpersonal skills to build client relations and ensure the delivery of the highest level of care.

   

• Demonstrated ability to evaluate provider performance and develop strategic plans.

   

• Must be able to manage provider performance for an assigned territory through a consultative approach.

Additional Information :

Location and Work Environment:

• Mandatory Location: Due to travel requirements we are seeking candidates who live specifically in Cobb Dekalb Fulton or Gwinnett County .

• Travel: This is a field-based role requiring local travel up to four (4) days a week .

  Salary Range: The base salary range is USD $55000 to $99000 per year.

About Our Client and Benefits:

• Our client is a diversified national organization committed to transforming the health of our communities.

   

• Total compensation may include additional forms of incentives.

   

• Benefits include: health insurance 401K and stock purchase plans tuition reimbursement paid time off plus holidays and a flexible approach to work.

Remote Work :

Yes

Employment Type :

Full-time