• Maintain partnerships between the health plan and the contracted provider networks serving our communities. • Build client relations to ensure delivery of the highest level of care to our members. • Engage with providers to align on network performance opportunities and solutions. • Consultative account management and accountability for issue resolution. • Drive optimal performance in contract incentive performance, quality, and cost utilization. • Serve as primary contact for providers and act as a liaison between the providers and the health plan. • Triages provider issues as needed for resolution to internal partners. • Receive and effectively respond to external provider related issues. • Investigate, resolve and communicate provider claim issues and changes. • Educate providers regarding policies and procedures related to referrals and claims submission. • Perform provider orientations and ongoing provider education. • Manages Network performance for assigned territory through a consultative/account management approach. • Completes special projects as assigned. • Complies with all policies and standards.