Provider Account Executive II - Remote - AZ

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:

• Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week

• Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week

• Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month

• Onsite: daily onsite requirement based on the essential functions of the job

• Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.

This remote work opportunity requires residency, and work to be performed, within the State of Arizona. 

PURPOSE OF THE JOB

The Provider Account Executive is the sole point of contact for high profile facilities and groups.  This role is responsible for coordinating all requests from their dedicated group(s) including claims issues, credentialing questions, roster verifications, precert coordination and other duties as assigned.

QUALIFICATIONS

REQUIRED QUALIFICATIONS

Required Work Experience

• 5 years experience in a provider relations role (level 1)
• 7 years experience in a provider relations role (level 2)
• 10 years experience in a provider relations role (level 3)

Required Education

• High-School Diploma or GED in field of study (Applies to All Levels)

Required Licenses

• Valid Arizona Driver License, with an acceptable driving record (Applies to All Levels)

Required Certifications

• N/A

PREFERRED QUALIFICATIONS

Preferred Work Experience

• N/A

Preferred Education

• Bachelor Degree (Applies to All Levels)

Preferred Licenses

• N/A

Preferred Certifications

• N/A

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

• Establish and maintain positive working relationships with assigned provider group(s)
• Facilitate at least monthly meetings with assigned groups to address concerns, share network updates, provide education, provide updates on corporate initiatives
• Ensure the resolution of provider inquiries and issues, identifying and escalating barriers to leadership for assistance
• Responds timely to provider calls and emails. Works collaboratively with internal teams to address provider complaints
• Ensure provider complaint tracking is completed and to the customer satisfaction
• Conduct and document provider visits. Provider visits must include reconciliation of provider rosters, review of any pertinent provider reporting including scorecards, quality reporting and other reports as identified.  Provider visits may also include site visits of physician offices to comply with BCBSAZ requirements in conjunction with CMS.
• The position requires the Account Executive to attend monthly onsite staff meetings and other meetings in person, as required.

ALL LEVELS

• Each progressive level includes the ability to perform the essential functions of any lower levels.

• The position has an onsite expectation of 0 days per week and requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements
• Perform all other duties or special projects as assigned.

COMPETENCIES

REQUIRED COMPETENCIES

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