Provider Engagement Account Manager (Healthcare)

Location: Remote within Alabama; candidates must live in a covered area supporting greater Montgomery, Opp, Andalusia, Troy, and Enterprise, with local travel required 4 days per week.

Salary: $56,200–$101,000 per year

Company

hirify.global is a health plan focused on connecting people and communities with the care they need.

What you will do

• Serve as the primary contact and liaison for contracted providers and the health plan.
• Triage, investigate, resolve, and communicate provider issues, claims issues, and demographic changes.
• Educate providers on referrals, claims submission, website usage, EDI, policies, and procedures.
• Conduct provider orientations and maintain orientation and education materials.
• Manage network performance through consultative account management and evaluate provider performance.
• Develop and drive improvement plans covering risk/P4Q, HEDIS and quality, health benefit ratio, cost, and utilization.

Requirements

• Must live in Alabama within one of the covered service areas.
• 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 four days per week.

Culture & Benefits

• Work focused on improving access to healthcare for individuals, families, and communities.
• Remote, hybrid, field, or office work schedules may be available depending on the role and circumstances.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Compensation is adjusted based on skills, experience, education, and other job-related factors.