layiq

/la·yiq/adjective

worthy; deserving; fitting; suitable.

A role, opportunity, or path that merits attention, time, and pursuit.

LAYIQ - Account Manager, Hospital Relations and Ancillary Relations (Health Plans) at VNS Health

Manage an assigned portfolio of hospital, health system, and ancillary provider relationships, serving as a primary point of contact for provider leadership and key operational stakeholders.
Build and maintain strong, collaborative provider relationships through regular meetings, business reviews, site visits, provider education, and ongoing communication.
Support hospitals and ancillary providers in navigating VNS Health Plans' operational processes, requirements, programs, and initiatives.
Coordinate the resolution of complex provider issues involving claims, billing, payment, configuration, credentialing, contracting, utilization management, quality, compliance, authorizations, provider data, and member services, partnering with the appropriate internal teams.
Serve as a liaison between providers and internal VNS Health departments to ensure issues are appropriately escalated, tracked, communicated, and resolved.
Educate hospital and ancillary provider partners on VNS Health Plans policies, procedures, operational requirements, Medicare and Medicaid programs, regulatory requirements, and new initiatives.
Support the implementation and ongoing administration of provider agreements in partnership with Contracting, Network, Provider Data, Operations, Claims, Quality, Utilization Management, and other applicable teams.
Review provider performance, operational, and utilization data to identify trends, discrepancies, risks, service issues, and opportunities for improvement.
Identify recurring or systemic provider issues and collaborate with internal stakeholders to support sustainable solutions and process improvements.
Conduct or support hospital and ancillary provider meetings, operational reviews, and site visit s
, ensuring provider concerns, action items, and commitments are documented and followed through.
Support provider onboarding, operational readiness, new program implementations, and changes impacting hospital and ancillary provider partners.
upport regulatory and internal audits, provider corrective actions, compliance activities, and other health plan initiatives as appropriate.
Maintain accurate documentation of provider interactions, issues, escalations, commitments, and follow-up activities in the appropriate systems.
Lead or participate in special projects and cross-functional initiatives impacting hospitals, health systems, ancillary providers, and the broader provider network.

Manage an assigned portfolio of hospital, health system, and ancillary provider relationships, serving as a primary point of contact for provider leadership and key operational stakeholders.
Build and maintain strong, collaborative provider relationships through regular meetings, business reviews, site visits, provider education, and ongoing communication.
Support hospitals and ancillary providers in navigating VNS Health Plans' operational processes, requirements, programs, and initiatives.
Coordinate the resolution of complex provider issues involving claims, billing, payment, configuration, credentialing, contracting, utilization management, quality, compliance, authorizations, provider data, and member services, partnering with the appropriate internal teams.
Serve as a liaison between providers and internal VNS Health departments to ensure issues are appropriately escalated, tracked, communicated, and resolved.
Educate hospital and ancillary provider partners on VNS Health Plans policies, procedures, operational requirements, Medicare and Medicaid programs, regulatory requirements, and new initiatives.
Support the implementation and ongoing administration of provider agreements in partnership with Contracting, Network, Provider Data, Operations, Claims, Quality, Utilization Management, and other applicable teams.
Review provider performance, operational, and utilization data to identify trends, discrepancies, risks, service issues, and opportunities for improvement.
Identify recurring or systemic provider issues and collaborate with internal stakeholders to support sustainable solutions and process improvements.
Conduct or support hospital and ancillary provider meetings, operational reviews, and site visit s
, ensuring provider concerns, action items, and commitments are documented and followed through.
Support provider onboarding, operational readiness, new program implementations, and changes impacting hospital and ancillary provider partners.
upport regulatory and internal audits, provider corrective actions, compliance activities, and other health plan initiatives as appropriate.
Maintain accurate documentation of provider interactions, issues, escalations, commitments, and follow-up activities in the appropriate systems.
Lead or participate in special projects and cross-functional initiatives impacting hospitals, health systems, ancillary providers, and the broader provider network.

Account Manager, Hospital Relations and Ancillary Relations (Health Plans)

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