Senior Provider Engagement Account Manager (Healthcare)

Location: Remote in Florida; candidates must live in Miami-Dade County and support Miami and surrounding areas. Local travel is required four days a week.

Salary: $70,100–$126,200 per year

Company

hirify.global provides health plan services designed to improve access to healthcare for individuals, families, and communities.

What you will do

• Build strategic partnerships with contracted providers and serve as the primary liaison between providers and the health plan.
• Manage provider performance through a consultative account-management approach.
• Identify, investigate, and resolve provider concerns, claims issues, and operational changes.
• Educate providers on referrals, claims submission, website usage, EDI, policies, and procedures.
• Evaluate network performance and develop improvement plans covering risk, quality, cost, and utilization.
• Prepare HBR analyses and reports for Joint Operating Committee meetings and coach less experienced external representatives.

Requirements

• Bachelor’s degree in a related field or equivalent experience.
• Three or more years of experience in managed care, medical groups, provider relations, quality improvement, claims, contracting, utilization management, or clinical operations.
• Project management experience in a medical group, IPA, or health plan environment.
• Strong communication and presentation skills.
• Proficiency in HEDIS and quality measures, cost, and utilization.
• Must be based in Miami-Dade County, Florida, and able to travel locally four days per week.

Culture & Benefits

• Health insurance and a comprehensive benefits package.
• 401(k) and stock purchase plans.
• Tuition reimbursement.
• Paid time off and holidays.
• Flexible remote, hybrid, field, or office work schedules, subject to role requirements.