LTSS Provider Relations Account Manager- Dayton & Cincinnati Metro

LTSS Provider Relations Account Manager-Must Travel to Dayton & Cincinnati Metro Areas

remote type

Mobile

locations

Ohio Mobile

time type

Full time

posted on

Posted 9 Days Ago

job requisition

R13707

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.

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

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…