Provider Engagement Account Manager (Healthcare)

Location: Remote in Tennessee; supports the upper half of West Tennessee and requires local travel 4 days per week.

Salary: $56,200–$101,000 per year

Company

Healthcare organization connecting people with care through health plan and provider network services.

What you will do

• Serve as the primary contact and liaison for contracted providers and the health plan.
• Triage provider issues, investigate claims problems, and coordinate resolution with internal partners.
• Educate providers on referrals, claims submission, website usage, EDI, policies, and procedures.
• Conduct provider orientations and ongoing education, including developing and updating materials.
• Manage network performance through consultative account management and evaluate provider performance.
• Drive improvement in risk and pay-for-quality performance, HEDIS and quality measures, cost, and utilization.

Requirements

• Must live in Tennessee.
• 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 with HEDIS and quality measures, cost, and utilization.
• Ability to travel locally 4 days per week.

Culture & Benefits

• Flexible remote, hybrid, field, or office work schedules.
• Health insurance, 401(k), and stock purchase plans.
• Tuition reimbursement, paid time off, and holidays.
• Work focused on improving healthcare access and outcomes for individuals, families, and communities.