Account Manager

Position Summary

Manage day to day payer engagement for assigned health plan contracts, including implementing new contractual requirements, monitoring overall contract compliance, ensuring performance expectations are met, and providing outstanding customer service both internally and externally.

Essential Functions

• In coordination with other members of the Business Development team, establish, develop, and maintain strong business relationships with health plan key contacts
• Coordinate account level communication between CCNC operations teams and payer
• Serve as the internal subject matter expert on assigned payer contracts
• Facilitate internal meetings to monitor payer specific performance and compliance with contractual obligations
• Successfully implement payer's deliverables to include addressing concerns, reporting on progress toward resolution of client concerns and issues, and providing regular, timely updates
• Monitor business critical decisions that may impact contractual deliverables and ensure on-going communication
• Plan, coordinate, document, and report on meetings, action items, and payer interactions throughout the contract duration
• Identify performance gaps and engage appropriate CCNC leadership and stakeholders to resolve barriers to meeting customer product / service requirements and performance expectations
• Analyze, explain, and articulate account specific performance trends
• Identify and engage appropriate resources from project management, statewide operations, and/or analytics and technology teams to ensure deliverables meet company and payer expectations
• Troubleshoot practice specific contract issues and facilitate timely resolution with the payer
• Develop and monitor an annual contract compliance plan for all assigned contracts
• Manage account risks by collaborating with Business Development team, leadership, and internal stakeholders to identify and implement appropriate mitigation strategies

Qualifications

Bachelor's degree in business, health sciences or related field (or alternative work experience) is required. Two to five years of experience working within a medical practice, provider organization, or health plan is required. Account management, client services, or related experience is preferred.

Knowledge, Skills and Abilities

Experience with Medicaid, Medicare, and health plan contracts

Analytical skills including problem resolution and strategic reasoning skills

Project management/organizational, attention to detail, and multi-tasking skills

Ability to work across and coordinate activities in a matrixed organization to achieve results

Excellent verbal and written communication skills

Ability to develop strong team relationships and bring individuals together to focus on team goals

Working Conditions

• The job environment is a combination of office, work at home, and medical facility environments
• Exposure to general office conditions as well as communicable diseases could occur
• Exposure to general office and household conditions including minor physical inconveniences, discomfort in the work setting, or sitting for moderate periods of time and repetitive wrist motion
• There is occasional lifting of 20-30 pounds necessary to complete a task
• Travel using personal vehicle may be required within the region and/or the State
• The job environment can be intense as high volume, repetitive work is an expectation
• Core Hours are 8:00am to 5:00pm, Monday - Friday