Corporate Provider Network Account Executive II

AmeriHealth Caritas Provider Network Management

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are 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 would like to connect with you.

Headquartered in Newtown Square, 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.

The AE II is responsible for assuring an adequate provider network is in place to meet state or CMS requirements for new products in new or existing markets. They will assist in creating an assessment of the market needs prior to beginning contracting efforts using CPNM Assessment tool, identify, recruit, negotiate, and implement contracts with providers, and remain current in all aspects of the RFP or Application requirements. They must be able to quickly develop relationships with key providers and provider associations to develop a provider network in a limited amount of time. They will also work with the Director of Provider Network Management New Business Implementation to develop business plans, process flows, and strategies for providers who meet the network needs. AE II's will also be responsible to work with the CPNM Managers to on-board new associates and provide mentorship to new members of the CPNM Contracting Team. The AE II is responsible for managing an ongoing Provider Network Management organization project or program, developing, implementing, and managing programs and projects that support / impact high dollar and high member provider groups. AE II's participate or independently develop and implement Provider Network education programs and materials (both internal and provider targeted) and is assigned to train, mentor, and support new AE's and assist AE I's in resolving / managing issues with Providers.

Education / Experience :

• Bachelor's Degree or equivalent experience
• 3 to 5 years experience in a Provider Services position working with providers
• 5 to 10 years experience in the managed care / health insurance industry with demonstrated strengths in : knowledge of Plan policies and procedures related to provider contracting, credentialing, billing and payment, incentive programs, and other key regulatory requirements.

Other Skills :

Our Comprehensive Benefits Package

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 and more.