What are the responsibilities and job description for the Network Account Manager position at Healthfirst?
- Serve as plan liaison for vendors/physicians/physician groups in a specified geographical area. Will be the main point of contact for all plan related issues including marketing, enrollment, contracting, billing and reimbursement.
- Responsible for the resolution of all issues, including those identified by the provider/vendor, and those identified internally that have an impact on the physician/vendor. Coordinates with all Healthfirst staff to assist as appropriate, including creating project plans, issue logs, conference calls, etc.
- Responsible for the provider/vendor recruitment process. Identify gaps, complete paperwork, etc.
- Schedule frequent and regular face-to-face contact with the practice locations/vendors to identify any issues and ensure plan visibility.
- Keep abreast of competitor activity, including new reimbursement and marketing strategies. Negotiate favorable/competitive rates with providers/vendors based on market trends.
- Conduct new provider/vendor orientation and identify opportunities for education on both clinical and administrative topics. Includes experts in the field of education as needed from in-house staff.
- Responsible for monitoring and reporting on providers/vendors' clinical quality & financial performance, working with their manager and other internal departments to create strategic improvement plans.
- Working under light supervision, maneuvers multiple tasks independently with a fast paced proactive vs. reactive approach to changing priorities while meeting departmental objectives. Attention to managing many details and remaining focused in an environment with distractions.
- Contribute creative solutions and ownership of daily assignments for seamless communication and systematic completion of routine and special projects. Follow protocols and use common sense to escalate situations to management appropriately.
- Handle other duties as assigned with the occasional need to work weekends, overtime and/or travel throughout the tristate area. Engage in mastering the Division's impact on Healthfirst, its Members, and Providers
Minimum Qualifications:
- High School Diploma or GED Equivalent
- Medicare and/or Medicaid managed care experience
- Excellent oral and written communication skills (Letter writing, Memo, and Email)
Preferred Qualifications:
- Bachelor’s Degree from an accredited institution
- Provider office operations experience
- Ability to understand Provider/vendor claims reimbursement
- Contract negotiation experience
- Bilingual fluency (reading, writing, speaking) Chinese or Spanish and English
- Exposure to multiple functions especially finance, business intelligence
- Experience with Microsoft office such as Excel, Outlook, and/or electronic archiving
Hiring Range*:
Greater New York City Area (NY, NJ, CT residents): $67,200 - $97,155
All Other Locations (within approved locations): $59,800 - $88,910
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
- The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.
Salary : $59,800 - $88,910
