Provider Network Account Executive (Onsite)

Responsibilities

• Support provider network development and network management strategies.
• Assist leadership with initiatives related to provider satisfaction, education, engagement, and communication.
• Support the organization's Single Case Agreement (SCA) strategy.
• Build, cultivate, and maintain strong relationships with contracted providers and provider organizations.
• Resolve provider concerns and disputes in a timely, professional, and compliant manner.
• Manage an assigned portfolio of provider accounts, including individual practices, multi-site practices, integrated delivery systems, and other healthcare organizations.
• Analyze provider performance data and implement strategies to strengthen provider relationships and improve outcomes.
• Conduct provider office visits and site visits as needed.
• Maintain a working knowledge of provider databases and communicate updates related to provider additions, terminations, and demographic changes.
• Collaborate effectively with internal departments including Claims, Provider Data Management, Credentialing, Payment Integrity, Contracting, Appeals, and other operational teams.
• Develop a strong understanding of provider contracts, performance expectations, and operational processes.
• Deliver provider orientation sessions, educational presentations, and ongoing training to support provider success.
• Recruit providers to address identified network adequacy gaps.
• Support provider contracting activities across multiple product lines, including: Long-Term Services and Supports (LTSS) Exchange Plans Dual Special Needs Plans (D-SNP) Fee-for-Service (FFS) agreements
• Long-Term Services and Supports (LTSS)
• Exchange Plans
• Dual Special Needs Plans (D-SNP)
• Fee-for-Service (FFS) agreements
• Support Value-Based Care (VBC) provider relationships and contract negotiations, as needed.

Education & Experience

Compensation

• The anticipated hiring range for this position is $71,600 to $97,500 annually.

Benefits

• The expected salary range for this position is listed above. Actual compensation will be determined based on experience and qualifications as well as internal equity and alignment with market data.
• At Enlightened, we pride ourselves on offering a comprehensive and industry-competitive benefits package to our full-time employees. Our benefits include:
• Medical/Dental/Vision Insurance with Health Savings Accounts (HSA)
• Flexible Spending Accounts (FSA)
• 401(k) Retirement Plan
• Paid Holidays, Vacation, & Sick Leave
• Professional Training & Development Reimbursement
• Please note, these benefits are available exclusively to full-time employees of Enlightened.

Equal Opportunity Statement