Provider Engagement Account Manager

Account Manager Opportunity

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Account Manager has geographic responsibility for the quality and economic performance of the physician practice with the goal of developing a high performing provider network within the State of Kansas and Missouri. This includes analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. The Account Manager will develop and sustain a solid day-to-day relationship with stakeholders, the physician and office staff to effectively implement the business solutions developed by the Client Services leadership team. They are accountable for overall performance and profitability for their assigned groups as well as ownership and oversight to provide redirection as appropriate and approved. The responsibilities of this position include capabilities in the following areas : strategic planning and analysis; understanding of HEDIS, Star ratings, accurate documentation and coding; highly developed communication skills; and the ability to develop clear action plans and drive process. Essential Job Functions include : educating providers to ensure they have the tools needed to meet quality, coding and documentation, and total medical cost goals per business development plans; developing strategies and create action plans that align provider pools and groups with company initiatives, goals, quality outcomes, program incentives, and patient care best practices; driving processes and improvement initiatives that directly impact revenue, HEDIS / STAR measures and quality metrics, coding and documentation process and educational improvements; conducting new provider orientations and ongoing education to provider and their staff on healthcare delivery products, health plan partnerships, processes, and tools; and using and analyzing data to identify trends, patterns and opportunities for the business and clients.

Primary Responsibilities include : solid analytical skills required to support, compile and report key information; driving processes that directly impact Revenue, HEDIS / STAR measures and Quality Metrics, and total cost of care, as appropriate; using data to identify trends, patterns and opportunities for the business and clients. Develop business strategies in line with company strategic initiatives; engaging provider staff and providers in analysis and evaluation of functional models and process improvements; identifying dependencies and priorities; evaluating and driving processes, provider relationships and implementation plans; producing, publishing and distributing scheduled and ad-hoc client and operational reports relating to the performance of related metrics and goals; collaborating with internal leaders to foster teamwork and build consistency throughout the market; serving as a liaison to the health plan and all customers; and having the ability to communicate well with physicians, staff and internal departments.

Required Qualifications include : 3+ years of experience in a related medical field or health plan setting; knowledge of state and federal laws relating to Medicare; solid working knowledge of Medicare health care operations including HEDIS, CMS reimbursement models, and Medicare Advantage; understanding of IPAs, Clinically Integrated Networks, Medicare Shared Savings Programs, capitation / value-based contracting, and narrow networks; proficiency in Microsoft Word, Excel and PowerPoint; ability to travel 25% of the time; Driver's License and access to reliable transportation.

Preferred Qualifications include : demonstrated ability to act as a mentor to others; demonstrated ability to communicate and facilitate strategic meetings with groups of all sizes; demonstrated ability to work independently, use good judgment and decision-making process; demonstrated ability to adopt quickly to change in an ever-changing environment; and proven solid business acumen, analytical, critical thinking and persuasion skills.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.