Experienced Remote Provider Network Account Manager III – Managed Care Contracting and Relationship Management Specialist

Introduction to Workwarp Workwarp is a leading organization in the healthcare industry, dedicated to providing innovative solutions and exceptional service to its clients and members. As a pioneer in managed care, we strive to create a healthier and more sustainable future for all. Our team is comprised of talented and passionate individuals who share our vision and are committed to making a positive impact. We are now seeking an experienced and skilled Provider Network Account Manager III to join our team and contribute to our mission. Job Summary The Provider Network Account Manager III is a critical role within our organization, responsible for managing all aspects of the provider contracting and relationship management process. This includes drafting, reviewing, negotiating, and implementing contracts, as well as building and maintaining positive working relationships with our network of providers. The successful candidate will have a deep understanding of managed care regulations, policies, and procedures, as well as excellent communication and negotiation skills.

Key Responsibilities

• Manage the provider contracting process, including drafting, reviewing, and negotiating contracts with providers and provider organizations
• Build and maintain positive working relationships with providers, including hospitals, physician groups, and ancillary services
• Conduct network adequacy analysis and provide data to inform contract negotiations and network development
• Ensure timely submission of provider data and facilitate remediation of data errors
• Monitor and manage network adequacy to ensure compliance with state and federal regulations
• Provide educational visits and orientation sessions to providers on our practices, policies, and requirements
• Resolve provider issues and concerns in a timely and professional manner
• Collaborate with internal stakeholders, including credentialing, quality improvement, and customer service teams
• Stay up-to-date with industry trends, regulatory changes, and best practices in managed care

Essential Qualifications

• Bachelor's degree in a related field, such as healthcare administration, business, or public health
• Minimum of 4 years of experience in contracting and/or regulatory analysis in managed care or healthcare industry
• At least 4 years of healthcare experience in managed care, physician group, clinical-based organization, and/or hospital/facility setting
• Excellent communication, negotiation, and interpersonal skills
• Strong analytical and problem-solving skills, with attention to detail and ability to manage multiple projects simultaneously
• Proficient in MS Office, including Word, Excel, and PowerPoint
• Ability to work in a fast-paced environment, independently and as part of a team

Preferred Qualifications

• Master's degree in a related field, such as healthcare administration, business, or public health
• Knowledge of ICD-9, ICD-10, and Current Procedural Terminology (CPT) codes
• Medical Coding Certification
• Proven ability to work with a diverse group of people, including physicians, support staff, coworkers, and management
• Demonstrated ability to research issues and bring about resolution either directly or with the assistance of others

Career Growth and Development At Workwarp, we are committed to the growth and development of our employees. As a Provider Network Account Manager III, you will have opportunities to:

• Develop your skills and expertise in managed care contracting and relationship management
• Take on additional responsibilities and contribute to special projects and initiatives
• Collaborate with internal stakeholders and external partners to drive business results
• Participate in industry conferences, training sessions, and workshops to stay up-to-date with industry trends and best practices
• Pursue professional certifications, such as Medical Coding Certification or other relevant designations

Work Environment and Company Culture

At Workwarp, we pride ourselves on our positive and supportive work environment. Our team is passionate about making a difference in the lives of our members and providers, and we are committed to creating a culture that is:

• Collaborative and team-oriented
• Innovative and forward-thinking
• Respectful and inclusive
• Focused on excellence and continuous improvement

Compensation and Benefits

We offer a competitive salary and benefits package, including:

• Comprehensive health, dental, and vision insurance
• 401(k) retirement plan with company match
• Generous paid time off and holiday schedule
• Opportunities for professional development and growth
• Flexible work arrangements, including remote work options

Conclusion

If you are a motivated and experienced professional looking to make a difference in the healthcare industry, we encourage you to apply for the Provider Network Account Manager III role at Workwarp. With your skills and expertise, you will play a critical role in managing our provider network and contributing to our mission of creating a healthier and more sustainable future for all. Apply now and take the first step towards a rewarding and challenging career with our team! Don't miss out on this exciting opportunity to join our team and make a positive impact in the healthcare industry. Apply now and start your journey with Workwarp today! Apply This Job Apply tot his job Apply To this Job