Manager, DSE Strategic Initiatives

The Senior Account Manager is committed to the development and supervision of a high performance provider network, through various provider engagement strategies which follow four core principles: Quality, Clinical Efficiency, Administrative Efficiency, and Population Health. The individual at this level functions as a cultural ambassador and strategy driver for Healthfirst. He/she will embody Healthfirst's Standards of Excellence through his/her workplace behavior. S/he will also promote and reinforce subordinate behavior that is consistent with Healthfirst's desired culture and fulfill his/her role in aligning Healthfirst's strategic initiatives with the desired organizational culture.

*Advance Healthfirst through superior customer service focused leadership in an assigned territory and team, which will help to optimize provider satisfaction

*Educate and train network representatives in key business principles around profitability, network adequacy, quality, etc.

*Promote successful internal collaboration within Healthfirst for our providers:

• Shared mutual goals by working directly with the hospital and affiliated provider teams to improve their clinical, quality and member satisfaction outcomes
• Provide effective education and communication of Healthfirst's benefits and policies, changes, and effects to individual practices
• Collaborate, develop, and deliver appropriate reports that allow provider partners to better manage their patient population (roster, care plans, quality reports, etc.)
• Propose and implement initiatives or process changes with providers that will ultimately encourage process improvements within the healthcare delivery/administrative structure
• Provide customer service focused leadership to optimize provider satisfaction through timely and accurate issue resolution
• Propose and implement initiatives or process changes with providers that will ultimately encourage process improvements within the healthcare delivery/administrative structure

*Manage projects

• Provides status of projects as well as ensures completion of projects assigned

*Provides coaching/mentoring for staff

*Identifies improvement for further training/education

*Critical thinking that solves problems with a logical, analytical discipline with a view on how decisions may impact provider/practice operations

*Understanding of various reimbursement methodologies as it relates to the community provider network

*Strong grounding of core principles and the role of hospitals within both Clinical Efficiency, Population Health, and Administrative Efficiency

*Proactively identify trends of issues, root causes and their magnitude, develop and implement action plans to closure

*Ability to review and draw conclusions from reports that integrate job knowledge and practical applications that answer or respond to a question or issue or may lead to other issues

*Fiscal understanding of reimbursement and utilization practices

*Ability to analyze reports related to provider performance and relate provider practice patterns to overall trends

*Negotiation skills which clearly allow for ranges of discussions with a clear line of escalation when necessary as well as presentation for approval from Senior Management

*Regulatory/ Legal understanding of the contracting logistics

*Solid understanding of terms of contracts and how they should be applied: financial, amendment, termination, etc.

*Understanding and ability to guide translation of contract terms into system rules, i.e., configuration, creation or amendment of new provider records and knowledgeable review to ensure accuracy of future claims

*Ability to guide and facilitate the team's contracting process from start to finish

Minimum Qualifications:

*High School Diploma or GED Equivalent

*Medicare and/or Medicaid managed care experience

*Provider office operations experience

*Ability to understand provider claims reimbursement

*Contract negotiation experience

*Professional writing skills (Letter writing, Memo and Email)

Preferred Qualifications:

*Bachelor's degree

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

EEO Law Poster and Supplement

All hiring and recruitment at Healthfirst is transacted with a valid "@healthfirst.org" email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $100,900 - $145,775
• All Other Locations (within approved locations): $86,500 - $128,690

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.