Provider Engagement Account Manager (Healthcare)

Location: Remote-NJ; field-based role requiring residence in New Jersey. Local travel is required four days per week.

Salary: $56,200–$101,000 per year

Company

hirify.global connects people with healthcare services through health plans and provider networks.

What you will do

• Serve as the primary contact and liaison for contracted providers and the health plan.
• Receive, triage, investigate, resolve, and communicate provider and claims-related issues.
• 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 develop improvement strategies.
• Drive improvements in risk and pay-for-quality performance, HEDIS and quality measures, cost, and utilization.

Requirements

• 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, clinical operations, or project management in a medical group, IPA, or health plan.
• Proficiency in HEDIS and quality measures, cost, and utilization.
• Must live in New Jersey and be authorized to work in the United States without employment-based visa sponsorship.
• Employment-based visa sponsorship is not available now or in the future, including H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, and CPT.

Culture & Benefits

• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Flexible work approaches, including remote, hybrid, field, and office schedules where applicable.
• Work focused on improving healthcare access and outcomes for individuals, families, and communities.
• Equal opportunity workplace committed to diversity and inclusion.