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The Provider Engagement Account Manager will maintain partnerships with health plan and provider networks, serve as the primary contact for providers, triage issues, handle claims, educate providers about policies, manage network performance, and drive improvements in care quality and cost. The role requires local travel and involves project management within a medical setting.

The Case Manager evaluates and coordinates care for members with significant mental and behavioral health needs. They assess member needs, develop care plans, educate members and families about available services, and facilitate access to community resources. Frequent home visits are required to assess member condition and facilitate education on treatment options and benefits. The role also includes providing feedback for improving service delivery and compliance with guidelines.

The Manager of Accreditation ensures compliance with NCQA and CMS standards, oversees accreditation preparation for health plans, conducts readiness assessments, manages policy reviews, and develops training initiatives to maintain accreditation standards.