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JOB SUMMARY
This job is the primary liaison between large/complex provider groups in the Organization network and the corporation. Will be responsible for cultivating relationships with large/complex provider groups to gain buy in and “sell” strategic initiatives for the purposes of piloting and implementing alternative care/reimbursement models. This job will maintain visibility in the provider community by representing the organization at various provider functions, meetings, and collaboratives. The incumbent will play an active role in network management, training, monitoring and enforcement of company policies and procedures while increasing provider efficiencies; participate as a regional representative on key operational/product/medical management/reimbursement projects/initiatives that impact providers (i.e. oncology pathways, tele-medicine, convenience care); recruit and introduce the Pay for Value (P4V) programs to the physician network; and work collaboratively with the physician practices that contract into the programs to reinforce and improve quality, to enrich the patient experience and to reduce the overall cost of care for members.
ESSENTIAL RESPONSIBILITIES
EDUCATION
Minimum
Substitutions
Preferred
EXPERIENCE
Minimum
Preferred
LICENSES AND CERTIFICATIONS
Required
Preferred
SKILLS
TRAVEL REQUIREMENT
25% - 50%
PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS
Position Type
Office-Based
Office-Based Positions
An employee in this position works in an office environment. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours.
Teaches/Trains others regularly
Occasionally
Travels regularly from the office to various work sites or from site-to-site
Occasionally
Physical Work Site Required
No
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$50,200.00Pay Range Maximum:
$90,300.00Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )
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Full Time
Insurance
$38k-46k (estimate)
05/09/2024
07/08/2024
highmark.com
WILMINGTON, DE
15,000 - 50,000
1996
NGO/NPO/NFP/Organization/Association
TIM CONSTANTINE
$10B - $50B
Insurance
Highmark Health provides healthcare services and financing network in Pittsburgh.
The job skills required for Provider Account Liaison include Presentation, Initiative, Health Insurance, Communicates Effectively, Innovation, etc. Having related job skills and expertise will give you an advantage when applying to be a Provider Account Liaison. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Provider Account Liaison. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Provider Account Liaison positions, which can be used as a reference in future career path planning. As a Provider Account Liaison, it can be promoted into senior positions as an Account Services Representative, Sr. that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Provider Account Liaison. You can explore the career advancement for a Provider Account Liaison below and select your interested title to get hiring information.