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Provider Relationship Account Director

  • Job Family: PND > Provider Relationship Account Mgmt
  • Type: Full time
  • Date Posted:
  • Anticipated End Date:
  • Reference: JR117626

Location:

  • Kansas
  • Kansas, Wichita
  • Kansas, Topeka
  • Kansas, Overland Park
  • Kansas, Kansas City

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Description

Location:  Topeka KS, Kansas City KS

Hours: M – F Standard Working Hours

Travel: Hybrid (1-2 days onsite per week) In state travel to clients as needed


Position Overview:

Responsible for developing and maintaining positive provider relationships with a portfolio of providers within a defined provider relationship account management cohort. May act as a primary point of contact and own relationship, end to end , post contract for strategic initiatives for select strategic providers with complex operating structures such as value-based payment arrangements and diverse integration/risk contracting strategies and/or other strategic growth partners. When acting as primary point of contact will advocate for their portfolio of strategic providers; fully understands their operating /business model and proactively identifies provider needs and recommends ways to improve existing relationships through best practices and manages relationships and provides leadership to dedicated matrixed teams. Conducts regular on-site and/or virtual/digital visits, communicates administrative and programmatic changes, and facilitates proactive education and the resolution of highly complex provider issues.

How You Will Make an Impact:

  • Serving as a knowledge and resource expert regarding the mos complex providers (such as National, Large, Value-Based and High Performing Providers); research, analyzes, and coordinates prompt resolution to complex provider issues and appeals through direct contact with providers and internal matrixed partners and strategies for resolution and escalation of issues and barriers to success as required

  • May be responsible for coordinating non-negotiated contracts for new and existing providers as needed

  • Expected to support and coordinate "tradeable" amendments on National Facility /Ancillary groups

  • Functions as a high-level technical resource in analyzing what is driving the issues and how to avoid future occurrences Leads Joint Operation Committees (JOC), driving the meetings in the discussion of issues and changes

  • Coordinates communications process on such issues as administrative and medical policy, reimbursement, and provider utilization patterns

  • Identifies and reports on provider utilization patterns which have a direct impact on the quality-of-service delivery

  • Organizes and executes external Provider Townhalls/Seminars and attend State Association conferences (e.g.: MGMA, AFP, AAP, HFMA)

  • Researches and analyzes issues that may impact future provider contract negotiations or jeopardize network retention

  • May provide mentorship, training, guidance to lower-level Provider Relationship Account Mgt. staff

Required Qualifications:

  • Requires a Bachelor's degree and a minimum of 5 years of Provider service experience including 3 years’ experience healthcare or provider environment; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

Travels to worksite and other locations as necessary.


 

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.comfor assistance.

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