Senior Provider Relationship Account Manager

Elevance Health

. Manage the intake, assessment, tracking, escalation, and resolution of provider participation changes .

Posted 9/18/2026full-timeWoodland Hills • California • United StatesSenior💰 $96,416 - $150,912 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in regulatory compliance, provider network management, and project management within the healthcare sector. Proficient in developing policies, conducting audits, and maintaining provider relationships to ensure quality service delivery.

Highest-signal resume keywords

Regulatory ComplianceProvider Network ManagementProject ManagementAuditingMedicaid Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Regulatory WritingGeoAccess AnalysisContinuity Of CareNetwork CertificationAnalytical SkillsCustomer ServiceProvider Contract NegotiationsRisk Mitigation StrategiesMetrics DevelopmentCompliance Reporting

Soft Skills

Cross-Functional LeadershipCommunicationProblem SolvingCollaborationTraining

Tools & Technologies

Microsoft WordMicrosoft Excel

Industry Keywords

HealthcareProvider ParticipationAccreditation StandardsRegulatory AuditsProvider Utilization PatternsProvider Satisfaction SurveysJoint Operation CommitteesCalifornia Office RequirementCOVID-19 VaccinationInfluenza Vaccination

About the role

Key responsibilities & impact

Manage the intake, assessment, tracking, escalation, and resolution of provider participation changes
Evaluate member and network impacts, including continuity of care, alternative provider access, member communications, and provider notices
Coordinate network adequacy analyses and regulatory submissions required by DMHC, DHCS, and other oversight entities
Coordinate responses to regulatory inquiries and ensure accurate, complete, timely supporting documentation
Lead regulatory audits, examinations, accreditation reviews, readiness assessments, and evidence preparation
Develop project plans, gap analyses, milestones, risk mitigation strategies, and leadership updates
Interpret laws, regulations, contractual requirements, and accreditation standards and provide guidance
Develop and maintain policies, procedures, audit tools, training materials, metrics, dashboards, and compliance reports
Identify regulatory and operational risks, recommend process improvements, and monitor remediation
Collaborate with clinical, quality, care management, health plan, growth, and vendor management teams
Serve as liaison with regulators, delegated entities, providers, vendors, and senior leadership
Develop and maintain provider relationships through on-site and virtual visits, communications, education, and issue resolution
Research complex issues affecting provider contract negotiations and network retention
Resolve complex provider issues and appeals with providers and internal partners
Coordinate Joint Operation Committees for provider groups
Assist with provider satisfaction surveys, corrective action plans, education, contract questions, and non-routine claim issues
Coordinate communications regarding administrative and medical policy, reimbursement, and provider utilization patterns
Identify and report provider utilization patterns affecting quality of service delivery
Organize external Provider Town Halls and seminars and attend state association conferences
Monitor department metrics, provider assignments, and daily activities; provide performance management, training, guidance, and workflow feedback

Requirements

What you’ll need

Bachelor’s degree required
Minimum of 5 years of customer service experience, including 2 years in a healthcare or provider environment; or an equivalent combination of education and experience
2+ years’ experience with regulatory compliance, accreditation, auditing, and provider networks strongly preferred
Medicaid experience strongly preferred
Experience with provider network changes, regulatory audits, network certification, GeoAccess analysis, continuity of care, or member communications preferred
Strong project management, analytical, regulatory writing, and cross-functional leadership skills preferred
Proficiency with Microsoft Word and Excel preferred
Ability to travel to the worksite and other locations as necessary
Must work within commuting distance of a California office
Associates are required to work at an Elevance Health location at least once per week, and potentially several times per week
Candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza, unless an acceptable explanation is provided

Benefits

Comp & perks

Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401(k) contribution and match
Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
Medical benefits
Dental benefits
Vision benefits
Short-term disability benefits
Long-term disability benefits
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Hybrid work flexibility
Accommodation support for the application process