Provider Account Liaison (Healthcare)

TL;DR

Provider Account Liaison (Healthcare): Managing relationships between complex provider groups and the organization to implement strategic initiatives and alternative reimbursement models with an accent on provider buy-in and network management. Focus on implementing Pay for Value (P4V) programs, improving quality of care, and reducing overall costs for members.

Location: Must be based in West Virginia (Hybrid/Working at Home)

Company

hirify.global is a leading healthcare organization focused on integrating insurance and care delivery to improve health outcomes.

What you will do

• Lead the education and implementation of provider network and contracting strategies for assigned large/complex provider groups.
• Manage strategic relationships with providers to anticipate problems, improve operational efficiencies, and achieve corporate objectives.
• Drive the implementation and direction of Pay for Value (P4V) relationships to lower unit costs and increase patient satisfaction.
• Act as a conduit between project teams and providers, gathering feedback to modify and optimize strategic initiatives.
• Communicate reimbursement changes, product portfolio updates, and new technology offerings through on-site visits and regional sessions.
• Collect market intelligence to support the strategic planning and design of products and networks.

Requirements

• Bachelor's Degree in Business or a Healthcare-related field.
• 5-7 years of professional experience in the healthcare or insurance industry.
• 3-5 years of experience in presenting complex concepts to various audiences.
• 3-5 years of project management experience with high accountability for meeting deadlines.
• Deep understanding of care delivery models, reimbursement methodologies, and the provider market.
• Knowledge of CMS laws, regulations, and HIPAA privacy and security guidelines.

Culture & Benefits

• Hybrid work arrangement combining office-based presence with working-at-home options in West Virginia.
• Exposure to high-level strategic initiatives in the healthcare reimbursement landscape.
• Collaborative environment working across a matrixed liaison role with various operations and support areas.