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Account Management Jobs in Harrisburg, PA

Client Relationship Manager

Integrated Resources, Inc

Harrisburg, Pennsylvania

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JOB DETAILS
JOB TYPE
Contractor
SKILLS
Adjudication, Comparative Analysis, Contract Management, Contract Negotiation, Customer Relationship Management (CRM), Fee Schedule, Government, Health Plan, Healthcare Administration, Healthcare Management, Healthcare Providers, Healthcare Reimbursement, Hospital, Maintain Compliance, Medicaid, Medicare, Policy Development, Pricing, Problem Solving Skills, Process Improvement, Provider Contracting, Reimbursement, Time Management
LOCATION
Harrisburg, Pennsylvania
POSTED
2 days ago
Client Relationship ManagerArtech is an employer-of-choice for over 5,800 consultants across the globe. We recruit top-notch talent for over 65 Fortune and Government clients coast-to-coast across the U.S., India, and China. We are one of the fastest-growing companies in the U.S. and this may be your opportunity to join us!Job DescriptionDuration: 12 Months Contract – To – HireLocation: Harrisburg / Pittsburgh PA• Responsible for development and management of provider networks for all products: Medicaid, and Medicare.• Responsible for hospital and physician network development and management.• Develops and recommends policy changes related to provider recruitment and contracting.• Recruits and negotiates contracts with specific providers within operational and potential new counties to meet company requirements.• Oversees training and communication for network providers and acts as a liaison with the provider community.• Ensures compliance with pricing guidelines established by AMFC and Plan.• Ensures provider contracting is consistent with claim payment methodologies.• Maintains familiarity with Medicare and State Medicaid fee schedules and reimbursement methodologies and analyzes comparable Plan pricing guidelines.• Resolves difficult complex contract issues to ensure that provider contracts are in compliance with state, federal, national accrediting agencies and Plan contracting guidelines.• Ensures that non-standard contract elements are communicated to appropriate departments and obtains AMFC and Plan approval prior to submission to provider.• Responsible for the accuracy and timely management of all provider contracts.• Responsible for implementation of electronic strategies for provider network to include increasing electronic claims submission and implementation of improved processes that result in increased auto-adjudication of claims.• Responsible for achievement of quality and health plan objectives through accomplishment of provider initiativesQualifications• Bachelor's degree in business or health related discipline such as Healthcare Administration or Healthcare Management or equivalent business experience required• Master's Degree highly preferred.• Minimum of 5 years provider contracting/reimbursement experience in healthcare setting required• 1-2 years Medicaid experience required

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Integrated Resources, Inc

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