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VS

Provider Engagement Account Manager

Veracity Software Inc
🇬🇦 Gabon
Remote
Manager or above
11 months ago
  • HEDIS
11 months ago
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Not enough detail in this posting to match

Provider Engagement Account Manager
Location: Remote – Georgia (Travel up to 4 days/week within Cobb, Dekalb, Fulton, or Gwinnett County)
Position Type: Full Time
TheProvider Engagement Account Manager serves as the key liaison between the health plan and contracted provider networks, ensuring alignment on performance goals and continuous improvement in patient care delivery. This role focuses onprovider relationship management,value-based care performance, andcost/utilization optimization. The position requires frequent in-person visits with providers and collaboration with internal teams to improve network quality, outcomes, and efficiency.
Key Responsibilities:
  • Serve as theprimary contact for network providers, maintaining strong partnerships and acting as liaison with internal teams.
  • Conductregular 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 executestrategic performance improvement plans to address risk, P4Q, HEDIS, and Health Benefit Ratio (HBR) metrics.
  • Coordinateissue resolution and escalation between providers and health plan departments.
  • Support the implementation ofvalue-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).
Required Qualifications:
  • Education: Bachelor's degree in a related field or equivalent experience.
  • Experience: Minimum2 years of provider engagement or account management experience within amanaged care organization, IPA, or health plan.
  • Demonstrated experience inprovider performance management, cost/utilization analysis, and value-based care models.
  • Strong understanding ofHEDIS/quality measures andmedical loss ratio (MLR).
  • Excellentcommunication, negotiation, and relationship management skills.
  • Proficiency with Microsoft Office tools and comfort interpreting data and performance reports.
  • Willingness and ability totravel up to 4 days/week across Georgia.
Preferred Qualifications:
  • Experience inproject management within a clinical or provider network environment.
  • Background inPopulation Health, Care Management, or Clinical Operations.
  • Experience facilitatingperformance management conversations with providers.
  • Strong problem-solving and analytical thinking abilities.

Recruiter Submission Template

Full Name:
Degree / University & Year of Completion:
Total Years of Experience in Healthcare / Managed Care:
Provider Engagement / Account Management Experience (Years):
Experience in Managed Care or Health Plan Environment (Yes/No – Details):
Experience Conducting Direct Provider Engagement (Yes/No – Details):
Experience Managing Provider Performance (Cost, Quality, Utilization):
Experience with Value-Based Care or Incentive Programs (Yes/No – Details):
Experience with HEDIS / Quality Measures (Yes/No – Details):
Experience with MLR / Cost Utilization Analysis (Yes/No – Details):
Project Management Experience in Healthcare Setting (Yes/No – Details):
Experience Using Data Analytics to Monitor Provider Performance (Yes/No – Details):
Experience Coordinating Provider Issue Resolution (Yes/No – Details):
Comfort Conducting Onsite Provider Visits (Yes/No):
Willingness to Travel up to 4 Days/Week within Georgia (Yes/No):
Residence Location (City / County – Must be within Cobb, Dekalb, Fulton, or Gwinnett):
Proficiency with Microsoft Office and Data Reporting Tools (Yes/No – Specify):
Experience Leading Performance Management Conversations with Providers (Yes/No – Details):
Motivation / Reason for Interest in this Role:
Contact Number:
Email ID:
LinkedIn Profile URL:
Full Address (Street, City, State, ZIP Code):
Notice Period (in weeks):
Current Work Authorization (U.S. Citizen / Green Card / Visa – Specify):
Expected Salary:
Are you open to weekly travel across assigned Georgia territory(Travel up to 4 days/week within Cobb, Dekalb, Fulton, or Gwinnett County)? (Yes/No):

Provider Engagement Account Manager · Veracity Software Inc

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