LTSS Provider Relations Account Manager- Dayton & Cincinnati Metro

Position: LTSS Provider Relations Account Manager-Must Travel to Dayton & Cincinnati Metro Areas
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* Job Summary:

** The LTSS Provider Relations Account Manager is responsible for working in a highly matrixed organization and influencing internal stakeholder relationships. This role will engage with LTSS and HCBS providers to build, manage and maintain relationships, with a strong focus on operational efficiencies, proactive engagement, and reduced burden which all leads to retention of provider relationships and improving member access to care.
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* Essential Functions:

*** Own the relationship with LTSS and HCBS providers with a proactive focus on overall provider satisfaction and retention
* Develop, maintain, and enhance relationships with key stakeholders including relevant provider associations.
* Act as a liaison and SME to providers and operations for the LTSS/HCBS provider network
* Work as community partner to assist LTSS/HCBS providers; develop education and establishing a proactive process for these providers.
* Work in collaboration with Operations and other internal stakeholders on provider issues including researching providers claim issues and provide a professional and comprehensive response to providers
* Work with leadership team to define deliverables and timelines
* Improve Electronic Visit Verification compliance rates for provider network
* Perform virtual and in-person initial onboarding and ongoing education to provider network.
* Prepare and lead internal and external meetings with key stakeholders
* Assist with the implementation of strategy on independent provider network
* SME for Waiver services for internal and external stakeholders
* Collaborate with Care Management, Incident Management and SIU to ensure providers are educated on billing practices.
* Provide education to internal and external partners on LTSS and HCBS services, billing, and portal support
* Responsible for understanding and educating providers on regulation changes
* Collaborate with leadership to ensure initiatives are properly managed
* Produce detailed reports, executive summaries, and business decision documents
* Provide clarification/verification for all levels regarding status/details
* May support other lines of business as needed
* Perform any other job duties as requested
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* Education and Experience:

*** Bachelor’s degree in project management, Business Administration, or other related field, or equivalent years of relevant work experience required
* A minimum of three (3) years of relevant account management, claims, operational and technical or business work experience is required.
* A minimum of two (2) years of relevant Provider Relations experience supporting LTSS and HCBS experience is required.
* Knowledge of Medicaid, Medicare, LTSS, and HCBS and is required
* Experience translating business and contractual requirements is required
* Experience with Facets and other operational systems preferred
* Accreditation experience preferred
** Competencies, Knowledge and

Skills:

*** Proficient in Microsoft Office tools, including Project, Word, and Excel
* Advanced troubleshooting, critical thinking, and problem-solving capabilities
* Proven ability to effectively interact with all levels of management within the organization
* Flexibility during organizational and/or business changes
* Demonstrate excellent analysis and collaboration skills
* Demonstrate sense of urgency
* Ability to effectively and efficiently work within a team
* Exceptional written and verbal communication skills
* Strong interpersonal and relationship building skills
* Ability to work independently and within a team environment
* Ability to multi-task and prioritize work to meet project deadlines
* Critical listening and thinking skills
* Time management skills
* Customer service oriented
* Decision making/problem solving skills
** Licensure and…