Provider Relations Account Executive managing relationships with IDD service providers. Ensuring network compliance, performance monitoring, and cross-functional collaboration for service delivery.
Responsibilities
Develop and maintain strong, collaborative relationships with IDD service providers to ensure network adequacy and quality standards are met.
Negotiate contracts and agreements with providers, ensuring compliance with regulatory requirements and organizational policies.
Monitor provider performance metrics and work with providers to implement corrective action plans when necessary.
Serve as the primary point of contact for providers, addressing inquiries, resolving issues, and facilitating communication between providers and internal departments.
Collaborate with cross-functional teams including care management, compliance, and finance to support provider network initiatives and improve service delivery.
Requirements
Bachelor’s degree in Health Administration, Business, Social Work, or a related field.
Minimum of 3 years of experience in provider relations, account management, or a similar role within the health care services industry.
Knowledge of intellectual and developmental disabilities (IDD) services and related regulatory environments.
Experience with Contract Management.
Relevant experience may substitute for the educational requirement on a year-for-year basis.
Master's degree in Health Administration, Business, Social Work, or a related field (preferred).
Experience working specifically with IDD provider networks or in managed care environment (preferred).
Familiarity with Medicaid and other public health care programs related to IDD services (preferred).
Advanced degree or certification in health care management or a related discipline (preferred).
Proficiency with provider network management software and data analytics tools (preferred).
Demonstrated ability to lead projects and collaborate across multidisciplinary teams (preferred).
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