Provider Engagement Account Manager

Location: Remote in South Carolina; local travel required 4 days per week.

Salary: $56,200–$101,000 per year

Company

hirify.global provides health plan services focused on connecting people and communities with accessible, effective healthcare.

What you will do

• Serve as the primary contact and liaison for contracted healthcare providers and the health plan.
• Investigate, resolve, and communicate provider issues involving claims, demographic data, referrals, and policy procedures.
• Educate providers through orientations, ongoing training, and updated educational materials.
• Manage network performance for an assigned territory through a consultative account management approach.
• Evaluate provider performance and develop improvement plans focused on risk, quality, cost, and utilization.
• Coordinate issue resolution with internal partners and complete assigned special projects.

Requirements

• Must live in South Carolina because the role requires local travel four days per week.
• 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 management, and utilization analysis.

Nice to have

• Experience in home health, skilled nursing facility, or LTSS operations.

Culture & Benefits

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