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Account Manager, CHOICE

Overview

Manages all aspects of provider relations within a specified geographic region. Regularly visits and maintains ongoing contact with existing/potential providers for recruitment, credentialing, re-credentialing and relationship building. Manages and oversees the implementation of provider contracts within assigned territory. Works under general supervision


Responsibilities
  • Manages all provider contracts in designated territory, including recruitment, credentialing, recredentialing and relationship maintenance through regular visits and ongoing contact with existing and potential providers.
  • Oversees implementation of contracts including entry on VNSNY computer systems, introduction to Regional and health plan staff, and inclusion in provider directories.
  • Prepares materials for and orient providers to contract terms and operating requirements; VNSNY CHOICE program and eligibility requirements, and service coordination.
  • Administers changes and renewals to provider contracts in conjunction with the Provider Relations management staff.
  • Monitors contract performance of network providers and serve as a liaison between the Regional Operations and the Provider to ensure the flow of information regarding and resolution of member service issues.
  • Coordinates site visits on a periodic basis.

Qualifications

Education:  Bachelor's degree or equivalent related work experience, preferably in health care setting required.

Experience:  Minimum three years health care experience, preferably in the area of Provider Relations required.  Knowledge of government programs, including Medicare and Medicaid preferred.


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ABOUT US

The Visiting Nurse Service of New York (VNSNY) is the nation's largest not-for-profit home- and community-based health care organization, serving the five boroughs of New York City, and Nassau, Suffolk, and Westchester Countries. For over 125 years, VNSNY has been committed to improving the health and well-being of people through high-quality, cost effective healthcare in the home and community. We offer a wide range of services, programs, and health plans to meet the diverse needs of our patients, members, and clients from before birth to the end of life. Each day, more than 13,000 VNSNY employees - including nurses, rehabilitation therapists, social workers, other allied professionals, and paraprofessionals - deliver compassionate care, unparalleled medical expertise, and 24/7 solutions and resources to more than 44,000 patients and members, helping them to live the best lives possible in their homes and communities.