Executive Job Description | Account Manager
Our client has an immediate opening for an experienced Account Manager.
Description:
Our client is a Medicare Advantage Institutional Special Needs Plan for eligible individuals residing in Medicare approved nursing facilities and assisted living communities. The Account Manager is responsible for the success of the business relationship between the company and its contracted facilities and PCPs as measured by the following business metrics: membership growth/maintenance, MLR reduction/maintenance, and Customer Satisfaction.
Responsibilities include:
1. As the company’s primary point of contact, works with key facility contacts (Administrator, DON, Business Office, etc.) to ensure operational needs are consistently met. Develops positive relationships with facility personnel, gathers customer satisfaction intelligence, and proactively works to facilitate constructive communication between the facility and the company through routine face-to-face contact.
2. Participates in development of a strategic plan for each facility and large group practice and monitors results against plan.
3. Facilitates monthly or quarterly Partnership meetings and assists in preparation of meeting materials:
• A/R Review
• Review Bonus Assessments/Reports (If applicable)
• Clinical update (Health Services)
• Discuss/plan resident events in the facility
4. Proactively facilitates issue resolution regarding membership, claim payment, provider accessibility, and customer service by documenting issues, engaging appropriate resources, and escalating unresolved issues as necessary. Provides monthly facility status reports for the local Leadership Team identifying common themes across facilities and relationship risks.
5. Consults with facility to assist in establishing their preferred ancillary provider network while offering a viable quality vendor selection, and works in conjunction with Network Development Manager to ensure availability of ancillary providers and PCPs within the facility. Manages and facilitates relationships with providers and works with Network Development Manager to resolve provider issues
6. Ensures provider’s understanding of the Fidelis care model and contract details.
Education and/or Experience:
• Bachelor's degree and three - five years of sales / account management experience.
• Extensive knowledge of and experience in the health care industry, managed care delivery systems, or provider service network maintenance/retention desired.
• Experience in long term care and knowledge of provider billing practices preferred.
Other Skills:
The ideal candidate will possess strong business acumen with an ability to understand underlying business drivers for both the company and our customers. Characteristics that will contribute to the individual’s success include: excellent communication, presentation and negotiation skills; ability to build long term relationships; capable of operating in a matrix-management environment; and strong team and customer orientation. To perform this job successfully, an individual should also have knowledge of MS Office software, including Excel, Word, Access, and PowerPoint.
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