Provider Relationship Account Manager

Join Our Extraordinary Team

Carelon Behavioral Health, formerly Beacon Health Options, is a proud member of the Elevance Health family of companies. We offer superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work / life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. Build the possibilities. Make an extraordinary impact.

Title : Provider Relationship Account Manager

Location : 9133 W. Russell Rd, Las Vegas, NV Hybrid : This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid / virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Provider Relationship Account Manager is responsible for providing quality, accessible, and comprehensive service to the company's provider community.

Primary duties may include but are not limited to :

• Develops and maintains positive provider relationships with the provider community by regular on-site and / or virtual / digital visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.
• Serves as a knowledge and resource expert regarding provider issues impacting provider satisfaction and network retention; researches, analyzes, and coordinates prompt resolution to complex provider issues and appeals through direct contact with providers and internal matrixed partners.
• Collaborates within a cohort of internal matrix partners to triage issues and submit work requests.
• Is generally assigned to a portfolio of providers within a defined cohort. Coordinates Joint Operation Committees (JOC) of provider groups, driving the meetings in the discussion of issues and changes.
• May assist with Annual Provider Satisfaction Surveys, required corrective action plan implementation and monitoring education, contract questions, and non-routine claim issues.
• Coordinates communications process on such issues as administrative and medical policy, reimbursement, and provider utilization patterns.
• Conducts proactive outreach to support the understanding of managed care policies and procedures, as well as on a variety of initiatives and programs.
• Participates in external Provider Townhalls / Seminars and attends State Association conferences (e.g. : MGMA, AFP, AAP, HFMA). Identifies and reports on provider utilization patterns which have a direct impact on the quality-of-service delivery.
• Researches issues that may impact future provider contract negotiations or jeopardize network retention.

Minimum Requirements :

For candidates working in person or virtually in the below locations, the salary range for this specific position is $69,048.00 - $103,572.00 USD.

Location(s) : Nevada

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and / or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market / business considerations.

No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the company's sole discretion unless and until paid and may be modified at the company's sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.