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Corporate Provider Network Account Executive

Corporate Provider Network Account Executive

AmeriHealth CaritasMesa, AZ, US
21 hours ago
Job type
  • Full-time
Job description

Corporate Provider Network Management Account Executive

Your career starts now. We're looking for the next generation of healthcare 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 healthcare 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 Newtown Square, PA, 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.

Role Overview : The Corporate Provider Network Management Account Executive is vital in building strong, high-performing provider networks that meet state and CMS requirements for new products and markets. In this fast-paced role, you'll identify and recruit key providers, negotiate contracts, and quickly establish trusted relationships with healthcare professionals and associations. You'll also help shape the network's strategy by developing business plans, process flows, and tailored solutions that align with organizational goals. If you thrive on collaboration, strategic thinking, and making a meaningful impact in healthcare access, this role offers an exciting opportunity to do just that.

Work Arrangement :

  • Remote - Associate can work remotely anywhere in the United States
  • Travel 50% to 60% travel required

Responsibilities :

  • Identifies, contacts, and solicits qualified providers to participate in the 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 applies to plan participation.
  • Submits accurate and complete provider application packages to the 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 identifying and creatively resolving problems 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 that help alleviate backlogs and ensure the optimal utilization of resources.

    • Education & Experience :

  • Bachelor's degree in business, Healthcare Administration, Healthcare Management, or other health-related disciplines. Master's Degree preferred.
  • 2 to 3 years of previous experience in Medicaid or Medicare Provider Contracting preferred.
  • 5 to 7 years of progressive business experience in provider network management.
  • In-depth knowledge of provider network management processes and programs, e.g., performance improvement plans (PIP), hospital savings programs, accountable care organizations, and patient-centered medical homes, is strongly preferred.

    • Licensure :

  • Valid driver's license and current auto insurance required.

    • Skills & Abilities :

  • 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 the 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.

    • Our Comprehensive Benefits Package :

    Flexible work solutions include 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, and more.

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    Corporate Account Executive • Mesa, AZ, US