Provider Engagement Account Manager Remote GA Based

Job Description

We are seeking a consultative Provider Engagement Account Manager to join a leading national health plan. This role is responsible for maintaining strategic partnerships with contracted provider networks and driving optimal network performance through a consultative account management approach. The successful candidate will be accountable for improving contract incentives, quality outcomes, and cost utilization.

Essential Duties & Responsibilities :

Direct Provider Engagement : Conduct regular in-person visits with physicians to provide real-time support, discuss performance metrics, and identify opportunities for improvement in patient care.

Relationship Management : Serve as the primary contact for providers and act as a liaison between the providers and the health plan. Receive and effectively respond to external provider-related issues, triaging them with internal partners as needed.

Performance Improvement : Evaluate provider performance and develop strategic plans to improve performance in key areas, including : Risk / P4Q, Health Benefit Ratio (HBR), HEDIS / quality , and cost utilization.

Value-Based Care : Focus on value-based care model initiatives, collaborating with physicians to align with performance-based agreements.

​​​​​​​ Compliance : Ensure compliance with all policies and standards

Qualifications : Qualifications

Education & Experience (Required) :

Bachelor's degree in a related field or equivalent experience.

Minimum of two (2) years of provider engagement or account management experience at a medical group, IPA, or health plan setting.

Project management experience is highly preferred.

Key Skills & Competencies :

Proficient in HEDIS / Quality measures , cost (MLR), and utilization metrics.

Strong interpersonal skills to build client relations and ensure the delivery of the highest level of care.

Demonstrated ability to evaluate provider performance and develop strategic plans.

Must be able to manage provider performance for an assigned territory through a consultative approach.

Additional Information

Location and Work Environment :

Mandatory Location : Due to travel requirements, we are seeking candidates who live specifically in Cobb, Dekalb, Fulton, or Gwinnett County .

Travel : This is a field-based role requiring local travel up to four (4) days a week .

Salary Range : The base salary range is USD $55,000 to $99,000 per year.

About Our Client and Benefits :

Our client is a diversified, national organization committed to transforming the health of our communities.

Total compensation may include additional forms of incentives.

Benefits include : health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work.

Compensation :

$45,000-$45,000 per year