Provider Relations Account Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the primary point of contact for all WTCHP Clinical Centers of Excellence.

• Establish and nurture executive-level relationships with CCE leadership.

• Serve as the internal expert on CCE-specific workflows and operational requirements.

• Coordinate CCE requirements with Benefits Administration, Member Services, Claims, Provider Network Management, and Operations leadership.

• Assist in the execution of new operational initiatives, enhancements in service delivery, and improvements in processes.

• Conduct regular business reviews that encompass performance metrics, operational priorities, quality initiatives, compliance needs, and strategic goals.

• Deliver CCE-focused insights to TPA leadership.

• Aid in the provision of CCE-related data, reporting, and tools that comply with CDC guidelines and WTCHP standards.

• Manage escalations and facilitate the resolution of issues affecting members.

• Ensure alignment with the WTCHP mission to support 9/11 responders and survivors.

• Oversee a minimum of 2+ staff members.

• Report to the Provider Network Lead.

• Travel occasionally for meetings with CCEs, CDC stakeholders, or internal leadership.

⛳️ Requirements

• A Bachelor's degree and 5+ years of relevant experience; work experience may be considered in place of a degree.

• Comprehensive understanding of all eight CCEs, including their structures, workflows, and operational methodologies.

• Hands-on experience with WTCHP CCEs prior to the current TPA contract; candidates lacking this experience will not be considered.

• Experience in supporting or collaborating with federal healthcare programs.

• Knowledge of CDC program standards and compliance expectations.

• Proven capability in managing executive-level provider relationships within large academic medical centers or integrated health systems.

• Strong skills in operational coordination.

• Ability to convert complex program requirements into actionable internal plans.

• Excellent communication, interpersonal, and problem-solving skills.

• Proven track record in managing escalations and driving resolutions across cross-functional teams.

• Preferred experience in provider network management, healthcare operations, care coordination, or case management programs.

• Preferred experience leading operational improvement initiatives within multi-stakeholder healthcare settings.

• Familiarity with data reporting workflows or program compliance processes in federal health programs is preferred.

• Ability to supervise/manage a minimum of 2+ staff members.

• US citizenship is not a requirement.

• MBI (T2) public trust requirement.

🏝️ Benefits

• Options for medical plans, some including Health Savings Accounts.

• Options for dental plans.

• Vision plan availability.

• 401(k) plan with pre- and post-tax contributions along with company matching.

• Flexible work weeks where feasible.

• Vacation, sick leave, and personal time off.

• Paid holidays.

• Paid parental leave.

• Military leave.

• Bereavement leave.

• Jury duty leave.

• Up to 160 hours of paid family leave within a rolling 12-month period for eligible employees.

• Short- and long-term disability benefits.

• Life insurance coverage.

• Accidental death and dismemberment insurance.

• Personal accident insurance.

• Critical illness insurance.

• Business travel and accident insurance.

• Remote work options.