Provider Account Manager - Strategic Accounts
Core
Primary relationship owner and executive liaison for strategically aligned provider groups, driving Value-Based Reimbursement (VBR) performance and Total Cost of Care (TCOC) reduction.
Role type
Senior Account Manager (Healthcare/Insurance)
Builds
Value-based care programs and provider relationships for Highmark Network members
Domain
Healthcare insurance and provider network management
Deliverable
client delivery
Required skills
Provider community management, Value-Based Reimbursement (VBR) strategy, Total Cost of Care (TCOC) analysis, HEDIS/STAR metrics optimization, stakeholder management, project management, policy interpretation, compliance knowledge (CMS/HIPAA)
Preferred skills
Advanced presentation skills, complex project leadership
Technologies
Microsoft PowerPoint, Excel, Word
Responsibilities
Lead and manage relationships with assigned providers to improve operational efficiencies; Drive VBR activities, education, and implementation of new tools; Communicate reimbursement policy changes and new technology offerings; Coordinate with internal contracting and operations teams to resolve provider issues; Maintain market knowledge of care delivery models and insurance industry trends.
Seniority
Senior, hands-on IC
