Provider Engagement Account Manager - Remote Eligible

Account Manager

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing Together.

The Account Manager has geographic responsibility for the quality and economic performance of the physician practice with the goal of developing a high performing provider network within the State of Kansas and Missouri. This includes analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning.

The Account Manager will develop and sustain a solid day-to-day relationship with stakeholders, the physician and office staff to effectively implement the business solutions developed by the Client Services leadership team. They are accountable for overall performance and profitability for their assigned groups as well as ownership and oversight to provide redirection as appropriate and approved. The responsibilities of this position include capabilities in the following areas: strategic planning and analysis; understanding of HEDIS, Star ratings, accurate documentation and coding; highly developed communication skills; and the ability to develop clear action plans and drive process.

If you are located near McPherson, Kansas, you will have the flexibility to work remotely as you take on some tough challenges.

Primary Responsibilities:

• Solid analytical skills required to support, compile and report key information
• Drive processes that directly impact Revenue, HEDIS/STAR measures and Quality Metrics, and total cost of care, as appropriate
• Use data to identify trends, patterns and opportunities for the business and clients. Develop business strategies in line with company strategic initiatives
• Engage provider staff and providers in analysis and evaluation of functional models and process improvements; identify dependencies and priorities
• Evaluate and drive processes, provider relationships and implementation plans
• Produce, publish and distribute scheduled and ad-hoc client and operational reports relating to the performance of related metrics and goals
• Collaborate with internal leaders to foster teamwork and build consistency throughout the market
• Serves as a liaison to the health plan and all customers
• Requires solid presentation skills, problem solving and ability to manage conflict and identify resolutions quickly
• Have the ability to communicate well with physicians, staff and internal departments

Required Qualifications:

• 3+ years of experience in a related medical field or health plan setting (network management, contracting and/or recruitment, or provider relations)
• Knowledge of state and federal laws relating to Medicare
• Solid working knowledge of Medicare health care operations including HEDIS, CMS reimbursement models, and Medicare Advantage
• Understanding of IPAs, Clinically Integrated Networks, Medicare Shared Savings Programs, capitation/value-based contracting, and narrow networks
• Proficiency in Microsoft Word, Excel and PowerPoint
• Ability to travel 25% of the time
• Driver's License and access to reliable transportation

Preferred Qualifications:

• Demonstrated ability to act as a mentor to others
• Demonstrated ability to communicate and facilitate strategic meetings with groups of all sizes
• Demonstrated ability to work independently, use good judgment and decision-making process
• Demonstrated ability to adopt quickly to change in an ever-changing environment
• Proven solid business acumen, analytical, critical thinking and persuasion skills

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.