Provider Account Executive

• Competitive benefits package with day one eligibility
• Employer covers 90% of monthly premium cost for health, dental and vision plans
• Annual employee bonus program to reward success
• Time away from work including paid holidays, paid time off and volunteer time off
• Professional development courses, mentorship opportunities and tuition reimbursement program
• Robust 401(k) with 50% match and end of year discretionary employer contribution
• Paid parental leave and adoption leave with adoption financial assistance
• Employee discount program

• Build and maintain positive physician/hospital relationships with focus on a collaborative approach to quality care, network development and stability, cost containment and identification and resolution of barriers to success
• Facilitate resolution of escalated or urgent provider issues that are unable to be resolved through standard processes or procedures
• Serves as a liaison to providers regarding contracting issues; ensures consistency with compensation and payment
• Partner with appropriate subject matter experts to share provider's comments and concerns
• Develop and deliver provider education regarding BlueKC directives, mandates, medical and payment policies, programs, and business needs
• Lead in-person provider visits (create agenda, facilitate meeting, capture action items, send notes and own follow - up to the visits/meetings)
• Collaboration with other internal partners, provider value-added consultation and solutions to assigned providers.
• Includes trends and outliers in populations, determining root causes to variances and summarize in understandable terms.
• Includes presenting at educational conferences, submitting data to newsletters, and provider educational webinars and on-site training to providers
• Present performance data to providers or provider organization management and discuss opportunities to improve performance.

Minimum Qualifications

• Bachelor's degree in Business, Health Care or Related Field
• 5 years of provider relations experience with demonstrated success in developing and maintaining excellent provider relations with all types of providers
• 5 years of experience working with and general understanding of claims coding, medical terminology, ICD and CPT coding systems
• 5 years of experience with health insurance plan, preferred Provider Relations, Marketing/Account Management experience
• Strong verbal and written communication skills
• Strong presentation skills
• Proficient in Microsoft (Word, Excel and PowerPoint)
• Experience with Benefit Designs, Product Offerings, Contracting and Payment Strategy