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Provider Engagement Account Manager

MDA Edge

Role overview

Qualifications

  • Bachelor's degree in a related field or equivalent experience
  • Minimum two years of provider engagement or account management experience
  • Background in managed care, health plan, IPA, or medical group settings
  • Proficiency in HEDIS and quality measures, cost (MLR), and utilization management

Responsibilities

  • Build and maintain relationships with providers to support high-quality, cost-effective member care
  • Serve as the main liaison between providers and the health plan
  • Address and resolve provider-related issues in collaboration with internal teams
  • Evaluate provider performance using data analytics and implement improvement strategies

Key facts

Hard skills

Provider Model Account Management Data Mining Value-Based Care Cost Management Utilization Management Project Management

Other skills

  • Communication
  • Relationship Building
  • Problem Solving

About the company

MDA Edge logo

MDA Edge

Business Consulting & Services

Our objective is to establish an exceptional ecosystem by connecting individuals, technology, and prospects through the application of human intelligence.MDA Edge is a process-oriented company and our expertise lies in providing comprehensive Workforce Solutions, specifically focusing on Contingent Staffing, Bulk/Project Staffing, RPO/KPO/BPO, and Direct Hire services. We cater to a wide range of industries, including Infrastructure Consulting, Engineering Consulting, IT Consulting, Healthcare, Life Sciences, Pharmaceutical Consulting, Consumer Goods, Education, Transportation & Logistics, Media & Entertainment, Telecom, BFSI, Manufacturing, Utilities & Energies, and Corporate Recruitment. Moreover, we have developed a dedicated focus on Government Consulting.Our company prides itself on a meticulous approach, ensuring that we meet your specific needs. We have established a robust network of highly skilled professionals who are readily available to fulfill your requirements. With a strong commitment to excellence, we consistently deliver exceptional results for clients in India, Denmark, France, Germany, Ireland, Japan, Spain, Thailand, the USA, Canada and Mexico, with ongoing expansion efforts to serve more new regions in the near future.We consistently uphold the highest standards of quality by providing resources, time, and materials to design, implement, and support efficient operations for organizations. Our track record of measurable accomplishments demonstrates our commitment to cultivating a balanced work and societal ecosystem.Our continuous growth, successful customer engagements, and strong customer retention exemplify our achievements. Furthermore, our passion lies in streamlining complex business processes through the application of suitable technology, which has been integral to our success.We extend an invitation to join our dynamic workplace, offering rapid growth opportunities, excellent employee benefits, and a positive work-life balance.

Company details

Company typeScaleup
IndustryBusiness Consulting & Services
Company size201 - 500

Links

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Job description

Position Overview: Maintain strong partnerships between the health plan and contracted provider networks. Serve as the primary contact for providers, addressing issues, improving performance, and ensuring quality care delivery.
  • Location: Georgia (Cobb, Dekalb, Fulton, or Gwinnett County)
  • Travel: Local travel up to 4 days per week
Key Responsibilities:
  • Build and maintain relationships with providers to support high-quality, cost-effective member care.
  • Serve as the main liaison between providers and the health plan.
  • Address and resolve provider-related issues in collaboration with internal teams.
  • Evaluate provider performance using data analytics and implement improvement strategies.
  • Drive enhancements in value-based metrics including Risk/P4Q, HBR, HEDIS, quality, cost, and utilization.
  • Conduct regular in-person meetings with physicians to review performance metrics and improvement opportunities.
  • Support provider engagement in value-based care models focused on quality outcomes and cost efficiency.
  • Manage assigned territory using consultative account management methods.
  • Complete assigned projects and ensure compliance with all company policies.
Education and Experience:
  • Bachelor's degree in a related field or equivalent experience.
  • Minimum two years of provider engagement or account management experience.
  • Background in managed care, health plan, IPA, or medical group settings.
  • Proficiency in HEDIS and quality measures, cost (MLR), and utilization management.
  • Experience in project management and value-based care conversations with providers.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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