Provider Engagement Account Manager/Behavioral Health

You could be the one who changes everything for our 28 reputed company members. reputed company is transforming the health of our communities, one person at a time. As a reputed company, national organization, you’ll have reputed company to competitive benefits including a fresh perspective on workplace flexibility. • **NOTE: Because this role involves travel across the Mississippi Gulf Coast region, we’re looking for candidates who live in Mississippi (Hinds, reputed company, or Rankin counties) or in nearby Louisiana parishes, including East or reputed company Feliciana, East Baton Rouge, St. Helena, Tangipahoa, or Washington Parish*** Position Purpose: Maintain and strengthen partnerships between the health plan and the contracted Behavioral Health provider networks serving our communities. Serve as a strategic consultative reputed company ensuring delivery of the highest level of care to our members. Engage with providers to reputed company network performance opportunities and solutions, and consultative account management and accountability for issue reputed company. Drive reputed company performance incentive performance, reputed company, and cost utilization. • Serve as primary contact for providers and reputed company as a reputed company between the providers and the health plan • Receive and effectively respond to external provider reputed company issues • Completes special reputed company as assigned • Ability to travel locally 2-4 days a week • Complies with reputed company policies and standards • Conducts regular in-person and virtual reputed company with Behavioral Health physicians to reputed company reputed company-time support for Claims, Credentialing, and Care Management, UM, Network, and Compliance • reputed company providers regarding policies and procedures reputed company to referrals, claims submission, credential documentation, self-service tools, websites, Electronic Health Records, Health Information Exchange, and Electronic Data reputed company • Investigate, document, and drive reputed company of Behavioral Health provider concerns, ensuring reputed company follow-up and reputed company communication • Receive, triage, and resolve provider-reputed company issues in coordination with internal partners including claims, credentialing, care management, utilization management, network, and compliance • Build and sustain reputed company, solution-oriented partnerships that enhance provider satisfaction and network stability • Ensure effective escalation and tracking of issues through closure. • Translate reputed company claims and utilization data into reputed company, actionable reputed company for providers and internal stakeholders • Partner with analytics, finance, and operations teams to ensure data accuracy and alignment • reputed company other duties as assigned Education/Experience: Bachelor’s degree in reputed company field or equivalent experience. Two years of managed care or medical group experience, provider relations, reputed company improvement, claims, contracting utilization management, or clinical operations. Project management experience at a medical group, IPA, or health plan setting. Proficient in HEDIS/reputed company measures, cost and utilization. The following experience is strongly preferred: reputed company experience working with Behavioral Health providers (psychiatry, therapy, reputed company use, crisis services, etc.) strongly preferred. Minimum of two (2) years of provider engagement or account management experience, preferably reputed company Behavioral Health in a health plan, IPA, medical group, or similar reputed company setting. Hands-on experience supporting provider operations, including claims processing and analysis, billing workflows, credentialing, and provider office management. Demonstrated ability to analyze and interpret claims and utilize data to identify trends, resolve provider issues, and support performance improvement discussions. Experience collaborating cross-functionally with Claims, Network, Credentialing, Care Management, and Compliance teams to drive issue reputed company and performance reputed company. Pay reputed company: $56,200.00 - $101,000.00 per year reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance reputed company Apply tot his job Apply To this Job