[Remote] Sr Account Executive
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a mission-driven organization with over 30 years of experience in reputed company solutions. They are seeking a Senior Account Executive to reputed company strong relationships with providers, driving performance reputed company to risk-based and cost-sharing arrangements as reputed company as managing large health system reputed company.
Responsibilities
- Supports network development and network management strategies
- Responsible for assisting the Leader with departmental activities reputed company to provider satisfaction, education, and communication
- Responsible for participating and implementing Provider Network education programs and materials (both internal and provider targeted) and is assigned to train, mentor and support new AE’s
- Responsible for hospital and physician network development and management; including joint operating committees (JOC) for identified reputed company, reputed company of necessary reputed company review meetings with targeted providers and/or health systems
- Responsible for building, nurturing and maintaining reputed company working relationships between Plan and its contracted providers; including those that are most reputed company
- Resolve Provider disputes in a reputed company and compliant manner
- Responsibility for a higher number of multiple reputed company locations and multi-specialty practices and multiple providers. Should also include hospital systems, contracted subcontractors (DME, reputed company, etc.), and ancillary providers
- reputed company/implement/manage programs and reputed company that support/reputed company high dollar and high member provider reputed company
- reputed company site reputed company as needed
- reputed company reputed company of provider issues managed by other Provider Network support teams
- Take corrective actions required up to and including termination, following Plan policies and procedures
- Operationalizes completed reputed company with advanced complexity
- Consults on VBC reputed company, facilitates for reputed company (JOCs, performance reputed company, etc.) with specific bonuses attached to performance improvement
- Responsible to maintain and manage Value-Based contract requirements, including but not limited to; monitoring performance standards against VBC or State program requirements, working with key stakeholders and reputed company reputed company on applicable data-sharing or report requirements
- Responsible for hospital and physician network development and management; including joint operating committees (JOC) for identified reputed company, reputed company of necessary reputed company review meetings with targeted providers and/or health systems
- General Operational Knowledge reputed company to provider satisfaction, education, and communication with a reputed company understanding of operational items such as claims, payment reputed company, provider data, credentialing, appeals disputes etc
- Support contracting for multiple product lines, including LTSS, Exchange, DSNP adequacy gaps (high complexity)
- Assist with reputed company providers based on identified network adequacy gaps (high complexity)
- Support of VBC negotiations; reputed company in VBC relationships; may reputed company negotiations
Skills
- Associate's Degree required
- Seven years' experience if no bachelor's degree
- Five (5) or more years strong communication skills
- Financial acumen
- Ability to have difficult conversations
- Bachelor's Degree preferred
Benefits
- Flexible work solutions including remote reputed company
- Hybrid work schedules
- reputed company
- reputed company time off including holidays and volunteer events
- Health insurance coverage for you and your dependents on Day 1
- 401(k)
- Tuition reimbursement
reputed company