Provider Engagement Account Manager (Healthcare)

Location: Remote-AZ; must live in Mohave County. Local travel is required 4 days per week.

Salary: $56,200–$101,000 per year

Company

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

What you will do

• Serve as the primary contact and liaison between contracted providers and the health plan.
• Receive, investigate, resolve, and communicate provider-related issues, including claims issues and changes.
• Coordinate issue resolution with internal partners and maintain provider demographic information.
• Educate providers on referrals, claims submission, website usage, EDI solicitation, policies, and procedures.
• Conduct provider orientations and ongoing education, including maintaining orientation materials.
• Manage assigned network performance and develop improvement plans covering risk, quality, cost, utilization, and contract incentives.

Requirements

• Must live in Mohave County, Arizona.
• Bachelor’s degree in a related field or equivalent experience.
• At least two 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 setting.
• Proficiency in HEDIS and quality measures, cost, and utilization.
• Ability to travel locally 4 days per week.

Culture & Benefits

• Work supports healthcare access and improved outcomes for members and communities.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Flexible work approaches may include remote, hybrid, field, or office schedules.
• Equal opportunity employment and consideration for qualified applicants with arrest or conviction records in accordance with applicable laws.