Provider Relations Account Manager, VNS Health Plans
VNS Health, New York, NY, United States
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
Personal and financial wellness programs
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
Manage all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.
Prepare materials for and orient providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.
Collaborate with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.
Monitor contract performance of network providers and serve as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.
Coordinate provider site visits as needed.
Coordinate and attend meetings to serve as a resource and address provider issues.
Update and maintain provider manuals with current Health Plan policies and procedures.
Update and proof provider directories.
Assist providers in triaging billing and claims disputes.
Participate and collaborate with Compliance on Department of Health and internal audits.
Participate in special projects and perform 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 area
Bilingual in Mandarin, Bengali or Urdu preferred
Minimum three years health care experience required
Knowledge of government programs, including Medicare and Medicaid preferred
Prior experience in Provider Relations preferred
Pay Range USD $30.71 - USD $38.41 /Hr.
About Us VNS Health is one of the nation’s largest nonprofit home and community‑based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well‑being is what drives us — we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community‑health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.
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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
Personal and financial wellness programs
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
Manage all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.
Prepare materials for and orient providers to contract terms and operating requirements, Health Plan program and eligibility requirements, and service coordination.
Collaborate with the Network Development and Contracting and Service Operations departments to administer demographic changes and renewals to provider contracts.
Monitor contract performance of network providers and serve as a liaison between the Health Plan and the Provider to ensure the flow of information regarding resolution of member service issues.
Coordinate provider site visits as needed.
Coordinate and attend meetings to serve as a resource and address provider issues.
Update and maintain provider manuals with current Health Plan policies and procedures.
Update and proof provider directories.
Assist providers in triaging billing and claims disputes.
Participate and collaborate with Compliance on Department of Health and internal audits.
Participate in special projects and perform 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 area
Bilingual in Mandarin, Bengali or Urdu preferred
Minimum three years health care experience required
Knowledge of government programs, including Medicare and Medicaid preferred
Prior experience in Provider Relations preferred
Pay Range USD $30.71 - USD $38.41 /Hr.
About Us VNS Health is one of the nation’s largest nonprofit home and community‑based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well‑being is what drives us — we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community‑health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.
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