Corporate Provider Network Account Executive | REMOTE
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Your career starts now. We're looking for the next generation of health care leaders.
At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.
Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at .
Responsibilities:
The Corporate Provider Network Management Account Executive is one of a team responsible for ensuring an adequate provider network is in place to meet state or CMS requirements for new products and/or new markets. This position will identify, recruit, negotiate and implement contracts with providers and must be able to quickly develop relationships with key providers and provider associations to develop a provider network in a limited amount of time. The Corporate PNM Account Executive may also develop business plans, process flows, and strategies for providers who meet the network needs.
Principal Accountabilities:
- Identifies, contacts, and actively solicits qualified providers to participate in Plan network in new and existing service areas.
- Negotiates hospital, physician and other ancillary contracts. Works with all levels of providers and types of provider systems.
- Communicates and follows up with prospective providers as assigned, until such provider submits application for plan participation.
- Submits accurate and complete provider application packages to Credentialing Department assuring timely credentialing.
- Documents issues impacting recruiting efforts.
- Remains current in all aspects of the RFP or Application requirements.
- Maintains accurate concise records of all provider contacts.
- Support team members in the identification and creative problem resolution for improved processes and expanded use of technology.
- Support collaborative team efforts that produce effective working relationships and trust.
- Regularly suggests innovative means of structuring operations in a fashion that helps alleviate backlogs and ensures the optimal utilization of resources.
Education/ Experience:
- Bachelor's Degree in Business or health related disciplines such as Healthcare Administration or Healthcare management or equivalent business experience. Master's Degree preferred.
- 2 to 3 years previous experience in Medicaid or Medicare Provider Contacting preferred.
- 5 to 7 years of progressive business experience in provider network management.
- Experience working across an enterprise and working in complex organizations.
- Strong understanding of customer and market dynamics and requirements.
- Ability to travel extensively to various locations for development of provider networks.
- Willingness to work in a national team of professionals.
- Strong negotiation and listening skills.
- Proven leadership and ability to drive results.
- In depth knowledge of Provider network Management processes and programs, e.g., PIP, Hospital Savings Programs, Accountable Care organizations and Patient Centered Medical Home strongly preferred.
- Valid Driver's License and current Auto Insurance.