Note: The job is a remote job and is open to candidates in USA. AmeriHealth Caritas is a mission-driven organization focused on delivering comprehensive health care solutions. The Account Executive role involves developing strong relationships with providers to enhance performance, particularly in fee-for-service programs, while managing provider satisfaction and education.
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 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 relationship
- Perform site visits as needed
- Maintains a functional working knowledge of provider database 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 VBC relationships and negotiations where needed
Skills
- Associate Degree Required
- One (1) or more years strong communications skills, would need to deliver provider education, training, and onboarding to large groups
- For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required
- Bachelor Degree Preferred
Benefits
- Flexible work solutions including remote options
- Hybrid work schedules
- Competitive pay
- Paid time off including holidays and volunteer events
- Health insurance coverage for you and your dependents on Day 1
- 401(k)
- Tuition reimbursement
Company Overview
Company H1B Sponsorship