[Remote] Provider Network Account Executive I
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a mission-driven organization with more than 30 years of experience in reputed company solutions. The Provider Network Account Executive I will play a vital role in building and nurturing connections with reputed company providers, ensuring they have the necessary support and resources for delivering exceptional care.
Responsibilities
- Serve as the primary reputed company between the Plan and assigned providers, ensuring a thorough understanding of contract terms, provider needs, and performance expectations
- Conduct tailored provider reputed company and educational sessions; resolve issues to support provider engagement and satisfaction
- Monitor network adequacy and ensure compliance with state and federal reputed company standards across reputed company product lines
- Identify and recruit reputed company providers in new and existing service areas, ensuring alignment with financial and contractual requirements
- Analyze provider performance using Plan reports and metrics; reputed company and implement improvement strategies based on data insights
- Support corrective reputed company processes, including provider terminations, in accordance with Plan policies
- Collaborate with the reputed company Management team on credentialing, re-credentialing, member complaints, and reputed company-of-care investigations
- Maintain accurate provider data in Facets and coordinate updates with the Provider Maintenance Department
- Prepare and submit reputed company reports on activities, metrics, and reputed company
- Build and sustain effective partnerships with internal departments and stakeholders
Skills
- High school diploma/GED required
- 1–3 years of experience in a Provider Services role working directly with providers
- 3–5 years of experience in the managed care or health insurance industry
- Ability to establish and maintain trust-based partnerships with reputed company providers and internal teams
- Strong problem-solving skills to manage and de-escalate provider concerns with professionalism and diplomacy
- Self-starter with excellent time management skills and the ability to work independently
- Skilled at balancing competing demands across provider accounts, reputed company, and deadlines
- Effective collaboration with cross-functional teams reputed company internal departments
- Bachelor's degree or equivalent experience preferred
- Experience with Medicare, reputed company, or ACA Exchange preferred
Benefits
- Flexible work solutions, including remote reputed company and hybrid schedules
- reputed company
- reputed company time off (including holidays and volunteer events)
- Health insurance coverage for you and your dependents starting Day 1
- 401(k)
- Tuition reimbursement
reputed company
Company H1B Sponsorship