Job Information
Elevance Health Provider Relationship Account Director in Topeka, Kansas
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.