Provider Relationship Account Manager

Anticipated End Date:

2025-08-23

Position Title:

Provider Relationship Account Manager

Job Description:

Be Part of an Extraordinary Team  

Provider Relationship Account Manager 

Location:  NV-LAS VEGAS, 9133 W RUSSELL RD

Hybrid: This role requires associates to be in-office 1 day per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. 

 

The Provider Relationship Account Manager is responsible for providing quality, accessible and comprehensive service to the company's provider community.

How you will make an impact: 

Primary duties may include but are not limited to:

• Develops and maintains positive provider relationships with the provider community by regular on-site and/or virtual/digital visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.
• Serves as a knowledge and resource expert regarding provider issues impacting provider satisfaction and network retention; researches, analyzes, and coordinates prompt resolution to complex provider issues and appeals through direct contact with providers and internal matrixed partners.
• Collaborates within a cohort of internal matrix partners to triage issues and submit work requests.
• Generally, is assigned to a portfolio of providers within a defined cohort. Coordinates Joint Operation Committees (JOC) of provider groups, driving the meetings in the discussion of issues and changes.
• May assist Annual Provider Satisfaction Surveys, required corrective action plan implementation and monitoring education, contract questions and non-routine claim issues.
• Coordinates communications process on such issues as administrative and medical policy, reimbursement, and provider utilization patterns.
• Conducts proactive outreach to support the understanding of managed care policies and procedures, as well as on a variety of initiatives and programs.
• Participates in external Provider Townhalls/Seminars and attends State Association conferences (e.g.: MGMA, AFP, AAP, HFMA). Identifies and reports on provider utilization patterns which have a direct impact on the quality-of-service delivery.
• Research issues that may impact future provider contract negotiations or jeopardize network retention.

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Minimum Requirements:  

• Requires a bachelor’s degree; minimum of 3 years of customer service experience including 2 years of experience in a healthcare or provider environment; or any combination of education and experience, which would provide an equivalent background.
• Travels to worksite and other locations as necessary.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $69,048.00 - $103,572.00 USD  

Locations: Nevada

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.