Demo

Provider Network Account Executive I

AmeriHealth Caritas
Southfield, MI Full Time
POSTED ON 4/7/2025
AVAILABLE BEFORE 4/22/2025

Responsibilities

  • Those most complex have a higher number of multiple practice locations, multi-specialty practices, multiple providers, and an extensive health system.
  • Those that impact a total member population of a minimum of 5,000 or more will focus on quality and population health initiatives.
  • Each plan determines the appropriate minimum number of member population impacts for the Provider Services AE I level according to its business environment.
  • Develop, implement, and manage programs and projects that support / impact high-dollar and member-provider groups.
  • Responsible for participating in or independently developing and implementing Provider Network education programs and materials (internal and provider targeted) and assigned to train, mentor, and support new AEs.
  • Assist AE I in resolving / managing issues with providers.

Education & Qualifications :

  • A bachelor’s degree or equivalent experience is required.
  • High School diploma required.
  • 3 to 5 years of experience in a provider services position working with providers.
  • 5 to 10 years of experience in the managed care or health insurance industry with demonstrated strengths in knowledge of Plan policies and procedures related to provider complaint resolution, provider credentialing, provider billing and payment, provider incentive programs, and other essential State and Federal regulatory requirements related to providers, claim adjudication systems, provider file database requirements and relevant software applications.
  • Working independently and managing complex projects and programs both as an independent owner and team leader, training and mentoring skills, interacting at an executive level internally and externally.
  • Substantive Account Executive experience with high impact, high dollar, extremely visible, and critical provider groups.
  • A valid driver’s license and automobile insurance are required.
  • At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

    We keep our associates happy so they can focus on keeping our members healthy.

    Our Comprehensive Benefits Package

    Flexible work solutions, including remote options and hybrid work schedules, competitive pay, paid time off, including holidays and volunteer events, health insurance coverage for you and your dependents on day one, 401(k) tuition reimbursement, and more.

    Generous paid time off and paid volunteer time off.

    Employer-matched 401(k) and additional non-elective contributions, starting on day one.

    Medical, dental, and vision plans — with coverage starting on day one.

    Employee assistance programs, fitness reimbursements, nutrition counseling, and more.

    Employer-paid life insurance, with opportunities to purchase additional coverage.

    Employer-paid short-term disability coverage and long-term disability coverage.

    Tuition assistance, including reduced tuition at certain schools.

    Financial assistance with adoption, including paid time off.

    Flexible spending and health savings accounts to pay for qualified expenses.

    Discount programs on entertainment, travel, and more.

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