Provider Engagement Account Executive (Queens / Bronx, NY - Hybrid)

Company Description

CRD Careers is a boutique recruitment agency specializing in Sales and HR placements.

We connect growth-minded companies with high-impact professionals who drive real results. Whether you're building a team or building a career, our approach is precise, people-first, and built for long-term success.

We don't do buzzwords-we do outcomes.

Job Description

Position Purpose : As a Provider Engagement Account Executive, you will own the strategic partnerships between the health plan and our contracted provider networks in the Queens and Bronx markets. You will serve as the primary C-suite liaison, driving performance improvement, value-based care initiatives, and operational excellence.

Key Responsibilities :

• Strategic Relationship Management : Cultivate deep relationships with hospital systems and large multi-specialty groups. Act as the primary point of contact for C-suite executives and provider leadership.
• Performance Improvement : Drive provider performance in critical metrics including HEDIS / Quality , Health Benefit Ratio (HBR), risk adjustment, and cost utilization.
• Value-Based Care : Lead initiatives to align providers with value-based performance (VBP) agreements. Use data analytics to track performance and offer actionable feedback to optimize patient care and cost-efficiency.
• Operational Solutions : Investigate and resolve complex, high-volume, or high-dollar claim issues. Educate providers on policies, referrals, claims submission, and EDI tools to prevent recurring issues.
• Reporting & Analytics : Present detailed HBR analysis and create comprehensive reports for Joint Operating Committee (JOC) meetings.
• Leadership : Act as a lead for external representatives, providing coaching, training, and mentorship to the broader team.
• Field Presence : This is a hybrid role requiring local travel (up to 4 days / week) to conduct in-person visits with physicians and administrators for real-time support and strategy alignment.

Qualifications

Education & Experience :

Key Skills & Competencies :

Additional Information

Why This Role Matches Your Career :

Benefits :

Next Steps : Click "Apply Now" to submit your resume. Our Talent Team will review your application immediately.