Note: The job is a remote job and is open to candidates in USA. AmeriHealth Caritas is hiring an Account Executive to develop and maintain provider relationships and support network development and provider satisfaction. The role manages provider accounts, resolves disputes, delivers education, uses data to improve relationships, and supports contracting and value-based relationships.
Responsibilities
- Supports network development and network management strategies
- Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication
- Assist in Single Case Agreement (SCA) strategy
- Responsible for building, nurturing, and maintaining positive working relationships between Plan and its contracted providers
- Resolve Provider disputes in a timely and compliant manner
- Servicing assigned provider accounts which may include single or multiple practices in single or multiple locations, integrated delivery systems or other provider organizations
- Uses data to develop and implement methods to improve relationships
- Perform site visits as needed
- Maintains a functional working knowledge of provider databases and routinely relays information about additions, deletions or corrections
- Identifies and maintains strong partnerships with appropriate internal resources and stakeholders
- General Operational Knowledge related to provider satisfaction, education and communication with a fundamental understanding of operational items such as claims, payment integrity, provider data, credentialing, appeals disputes etc
- Maintains in depth understanding of Plan’s contracts and provider performance and needs, identifying, and conducting relevant and tailored provider orientation sessions, making educational visits and working to resolve provider issues
- Assist with recruiting providers based on identified network adequacy gaps (high complexity)
- Support contracting for multiple product lines, including LTSS, Exchange, DSNP could be asked to complete straightforward FFS contracts
- Support of value-based contracts (VBC) relationships and negotiations where needed
Skills
- Associate degree required or 1 or more years as an Account Executive
- 1 or more yearsstrong communications skills, deliver provider education, training, and onboarding to large groups
- Strong verbal and written communication skills
- Ability to deliver provider education, training, orientation, and onboarding to large groups
- Relationship-building and provider account management skills
- Ability to resolve provider disputes and operational issues promptly and compliantly
- Analytical skills, including the ability to use data to improve provider relationships and performance
- Strong collaboration skills for working with internal stakeholders and external providers
- Organizational skills with the ability to manage multiple provider practices, locations, or organizations
- Proficiency in maintaining provider databases and communicating additions, deletions, and corrections
- Ability to work independently
- Bachelor's degree Preferred
Benefits
- Remote work (must reside in Louisiana and attend site visits to providers and in-office meetings in Baton Rouge).
Company Overview
Company H1B Sponsorship