Provider Relations Account Manager – World Trade Center Health Program

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

📋 Description

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

• Build and sustain relationships at the executive level with CCE leadership.

• Serve as the internal expert on CCE-specific workflows, case management models, member coordination processes, operational requirements, and TPA provider-network interactions.

• Coordinate the needs of CCE across Benefits Administration, Member Services, Claims, Provider Network Management, and Operations leadership.

• Assist with new operational initiatives, enhancements to service delivery, and improvements to processes that impact CCEs.

• Foster collaboration, accountability, customer service excellence, and ongoing process improvement in provider engagement activities.

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

• Offer CCE-focused insights to TPA leadership regarding program operations, member experience, and provider network strategies.

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

• Oversee escalations and coordinate the internal resolution of issues affecting members to ensure timely closure.

• Ensure that provider engagement activities align with the WTCHP mission, which supports 9/11 responders and survivors.

• Report to the Provider Network Lead.

⛳️ Requirements

• Bachelor's degree and 5+ years of relevant experience; work experience may substitute for a degree.

• Direct, hands-on experience with WTCHP Clinical Centers of Excellence prior to the current TPA contract; candidates lacking this experience will not be considered.

• In-depth functional knowledge of all eight CCEs, including their structures, workflows, and operational practices.

• Experience in supporting or collaborating with federal healthcare programs.

• Familiarity with CDC program standards and compliance expectations.

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

• Strong operational coordination abilities and skill in translating complex program requirements into actionable internal plans.

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

• Demonstrated proficiency in managing escalations and facilitating resolution across cross-functional teams.

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

• Preferred: experience leading operational improvement initiatives in multi-stakeholder healthcare environments.

• Preferred: knowledge of data reporting workflows or compliance processes within federal health programs.

• No security clearance is required; MBI (T2) public trust or other requirements apply.

• US citizenship is not mandatory.

• Travel required is less than 10%.

🏝️ Benefits

• Options for medical plans, including those with Health Savings Accounts.

• Choices for dental plans.

• Vision plan availability.

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

• Flexible work weeks where feasible.

• Leave options including vacation, sick, personal, holiday, parental, military, bereavement, and jury duty leave.

• Typically, 15 days of paid leave each calendar year for new employees.

• 10 paid holidays annually.

• 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 arrangements available.

• Identity verification process utilizing biometrics and artificial intelligence.