Account Manager, Provider Relations

Overview

Manages all aspects of provider relations within a specified geographic region. Regularly visits and maintains ongoing contact with existing/potential providers for relationship building, recruitment, credentialing, re-credentialing and assisting with provider issues and education. Works under general supervision.

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched 401k retirement saving program
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care and commuter transit program
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement and CEU credits

What You Will Do

• Manages all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.
• Prepares materials for and orient providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.
• Collaborates with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.
• Maintains contract performance of network providers and serves as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.
• Collaborates with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.
• Coordinates provider site visits, as needed.
• Coordinates and attends meetings to serve as a resource and addresses provider issues.
• Updates and maintains provider manuals with current Health Plan policies and procedures.
• Updates and proofs provider directories.
• Affords assistance in triaging billing and claims disputes.
• Participates and collaborates with Compliance on Department of Health and internal audits.
• Participates in special projects and performs other duties as assigned.

Qualifications

• Licenses and Certifications: Driver's license required
• Education: Bachelor's Degree or equivalent related work experience, preferably in health care setting required
• Work Experience: Must be local to the New York City metropolitan areaBilingual in Mandarin, Bengali or Urdu preferredMinimum three years health care experience required
• Knowledge of government programs, including Medicare and Medicaid preferred
• Prior experience in Provider Relations preferred

About Us

VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.