CrawlJobs Logo
Healthfirst Logo Healthfirst · Customer Service

Ancillary Services Network Account Manager I

United States · Job Posted May 27, 2026
Apply Position
Job Link Share

Job Description

Under the direction of the Manager of Ancillary Services, the Ancillary Services Contractor develops and maintains an Ancillary provider network that ensures Healthfirst members have superior access to the highest quality by focusing efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction.The individual must possess experience working in a managed care setting with specific background in network development, provider recruitment, provider outreach, claim resolution, provider education and contract negotiations. Works with multiple provider types, e.g. physician, ancillary, medical groups, behavioral health or hospitals to supports a full range of contract arrangements and pricing mechanisms.

Job Responsibility

  • Manage a network of Ancillary Providers for all lines of Healthfirst's business (such as Medicaid, CHP, Medicare, and Commercial)
  • Monitor and audit contracted ancillary providers to ensure that accurate demographic, payment and fee schedules are loaded into the HF Provider System correctly
  • Resolve configuration issues by identifying root causes in order to prevent claims denials and to ensure claims are paid correctly
  • Facilitate meetings cross-departmentally to achieve positive outcomes in management of ancillary provider network
  • Create contracts in HF contract software and review credentialing documents submitted by Provider/facility via Universal Credentialing Data Source, The Council for Affordable Quality Healthcare (CAQH) or PDF application to ensure that all the required credentials are included and that valid documents for behavioral Providers and facilities are provided
  • Negotiate and execute Single Patient Agreements for Out Of Network (OON) Providers in order to determine the Provider's payment arrangement
  • Educate newly credentialed Providers on Healthfirst's policies and procedures such as billing and authorization requirements, utilization of Healthfirst's Provider portal, claims submission, etc., via various methods (telephonic, face-to-face, webinar, etc.)
  • Analyze provider network based on monthly report to ensure that Plan is meeting Health Plan Network (HPN) State requirements
  • Identify root cause of claims issues and facilitate resolution by working closely with Reimbursement and Claims departments
  • Clearly communicate resolutions and progress to the Providers
  • Assist Appeals and Grievances (A&G) department by acting as liaison between Providers and A&G department to achieve favorable outcomes of member related issues, complaints, balance billing and other issues
  • Ensure that all Providers’ inquiries received via email and phone call are addressed efficiently and effectively within required time-frame
  • Assist management with research and facilitation of projects related to contract updates, new product implementation and new reimbursement methodologies
  • Additional duties as assigned

Requirements

  • Experience managing or performing high level servicing to a portfolio of customers/providers
  • Contracting experience - Ability to work independently in dynamic environment
  • Ability to take initiative and work independently
  • Ability to prioritize and multi-task
  • Strong customer-centric and analytical skills
  • Strong sense of urgency and self-motivational qualities
  • Excellent oral and written communication skills
  • High School Diploma or GED

What we offer

  • medical, dental and vision coverage
  • incentive and recognition programs
  • life insurance
  • 401k contributions
Healthfirst - All Job Offers

Looking for more opportunities?

Search for other job offers that match your skills and interests.

Suggested Tags: Frontend Developer Secretary Talent Manager Salesforce Administrator Data Analyst
Similar Jobs for

Ancillary Services Network Account Manager I

8 matching positions

Ancillary Services Network Account Manager I

Under the direction of the Manager of Ancillary Services, the Ancillary Services...
Location
Location
United States
Salary
Salary:
61300.00 - 99620.00 USD / Year
healthfirst.org Logo
Healthfirst
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Experience managing or performing high level servicing to a portfolio of customers/providers
  • Contracting experience - Ability to work independently in dynamic environment
  • Ability to take initiative and work independently
  • Ability to prioritize and multi-task
  • Strong customer-centric and analytical skills
  • Strong sense of urgency and self-motivational qualities
  • Excellent oral and written communication skills
  • High School Diploma or GED
Job Responsibility
Job Responsibility
  • Manage a network of Ancillary Providers for all lines of Healthfirst's business (such as Medicaid, CHP, Medicare, and Commercial)
  • Monitor and audit contracted ancillary providers to ensure that accurate demographic, payment and fee schedules are loaded into the HF Provider System correctly
  • Resolve configuration issues by identifying root causes in order to prevent claims denials and to ensure claims are paid correctly
  • Facilitate meetings cross-departmentally to achieve positive outcomes in management of ancillary provider network
  • Create contracts in HF contract software and review credentialing documents submitted by Provider/facility via Universal Credentialing Data Source, The Council for Affordable Quality Healthcare (CAQH) or PDF application to ensure that all the required credentials are included and that valid documents for behavioral Providers and facilities are provided
  • Negotiate and execute Single Patient Agreements for Out Of Network (OON) Providers in order to determine the Provider's payment arrangement
  • Individual should be familiar with contracting and reimbursement methodologies for ancillary services providers
  • Educate newly credentialed Providers on Healthfirst's policies and procedures such as billing and authorization requirements, utilization of Healthfirst's Provider portal, claims submission, etc., via various methods (telephonic, face-to-face, webinar, etc.)
  • Analyze provider network based on monthly report to ensure that Plan is meeting Health Plan Network (HPN) State requirements
  • The individual would work closely with Network Management, Credentialing, and the business analytics unit within the Ancillary department, to complete the analysis
What we offer
What we offer
  • medical, dental and vision coverage
  • incentive and recognition programs
  • life insurance
  • 401k contributions
  • Fulltime
Read More
Arrow Right

Manager, Network Management

The Contract Manager, Physician & Ancillary Negotiations serves as an integral m...
Location
Location
United States of America , Richmond
Salary
Salary:
Not provided
thecignagroup.com Logo
The Cigna Group
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 3+ years Healthcare Provider Contracting and Negotiating experience involving complex Physician Groups and Ancillaries required
  • Experience in a Managed Care, Healthcare or Health Insurance environment
  • Experience with Commercial Healthcare contracting
  • Significant experience leading and mentoring others
  • Experience in developing and managing key provider relationships
  • Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred
  • Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners
  • Intimate understanding and experience with hospital, managed care, and provider business models
  • Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization
  • The ability to influence both sales and provider audiences through strong written and verbal communication skills
Job Responsibility
Job Responsibility
  • Manages complex contracting and negotiations for fee for service and value-based reimbursements with large Physician groups, Ancillaries and Hospital systems
  • May lead a team with direct reports
  • Point person for complex projects related to contracting strategy in the market
  • Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy
  • Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service
  • Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements
  • Contributes to the development of alternative network initiatives
  • Supports and provides direction to develop network analytics required for the network solution
  • Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position
  • Creates and manages initiatives that improve total medical cost and quality
Read More
Arrow Right

Vice President, Sales

The Vice President of Sales — Full-Service Hotels is the senior sales leader res...
Location
Location
United States , Irving
Salary
Salary:
Not provided
spirehotels.com Logo
Spire Hospitality
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum 10 years of progressive hotel sales experience, with at least 4 years in a multi-property or regional sales leadership role
  • Minimum 6 years of direct full-service hotel sales experience
  • deep understanding of full-service group, catering, and corporate transient dynamics
  • Demonstrated success leading both group and corporate/transient sales functions with measurable revenue and market share results
  • Proven experience managing and developing a layered sales team (regional managers and/or multiple Directors of Sales simultaneously)
  • Strong knowledge of the group sales process from prospecting through contract execution, including intermediary relationships and RFP management
  • Fluency with major brand sales platforms and distribution tools (Marriott, Hilton, IHG, or comparable)
  • experience navigating brand loyalty and preferred program environments
  • Proficiency with CRM platforms (Salesforce, Amadeus Delphi FDC, or comparable) and STR/competitive set reporting
  • Established network of group intermediaries, corporate travel buyers, and national account contacts
Job Responsibility
Job Responsibility
  • Develop and execute a comprehensive sales strategy for all full-service properties spanning group, corporate transient, and consortia segments
  • Establish annual sales production goals, booking pace targets, and account penetration benchmarks by property, region, and segment
  • Translate portfolio-level commercial priorities into clear, property-specific sales plans with measurable outcomes
  • Monitor competitive set performance and market demand trends
  • proactively adjust sales tactics to capture share and defend existing accounts
  • Partner with the COO to align full-service sales execution with Spire's enterprise commercial strategy
  • Represent the sales function in owner presentations, asset management reviews, and Spire executive leadership meetings
  • Drive group room night production across all full-service properties, including meetings, conventions, association business, corporate groups, and social/wedding segments
  • Build and maintain a robust national account base and key intermediary relationships (HelmsBriscoe, ConferenceDirect, Maritz, and other third-party planners)
  • Establish and enforce group booking pace standards, lead-to-contract conversion benchmarks, and group displacement guidelines in coordination with revenue management
What we offer
What we offer
  • Medical
  • Dental
  • Vision
  • Pet discount program
  • Identity theft protection
  • Pre-paid legal support
  • Flexible spending accounts
  • Matched 401K
  • Life insurance
  • Critical accident or illness
  • Fulltime
Read More
Arrow Right

Customer Support Engineer II

The Customer Support Engineer II is responsible for providing outstanding techni...
Location
Location
South Africa , Johannesburg
Salary
Salary:
Not provided
nintex.com Logo
Nintex
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor’s in business, computer science or related field
  • Experience with K2 is highly desirable
  • At least 3 years in a customer support role that involved technical troubleshooting, ideally a third party enterprise application (NB: not helpdesk!)
  • Experience and knowledge of Microsoft server environments (Windows admin, virtualisation, AD/AAD/Entra, network, load balancing, etc)
  • Experience and knowledge of SQL databases and administration
  • Experience administering and troubleshooting Sharepoint, either on-premise or online
  • Experience using or supporting a workflow product, especially in an on-premise environment e.g. Power Automate, IBM BAW, Oracle BPM
  • Experience with authentication technologies e.g. Web services, OAuth, SCIM, etc
  • Any form of application development experience is a bonus
Job Responsibility
Job Responsibility
  • Using the company CRM, Phone or Chat, interact with external customers and partners to resolve all technical issues with Nintex’s products and environments where Nintex products are deployed
  • The role will be an internal escalation point before a case is moved to development including the ability to identify the customer impact, the customer base impact, and how to prioritize
  • Perform complex troubleshooting for the product the role supports including, but not limited to
  • advanced SharePoint configuration, Network Load Balancing, Managed Services Configuration, SQL database layout, code review / scripting, and solution advice and queries
  • Use company and third-party training sites to grow your own knowledge and stay at the forefront of software technology stacks used by Nintex and its customers and become a subject matter expert
  • The customers must be the central focal point in all interactions, and you will act as the voice of the customer in all interactions ensuring all defined SLA’s are adhered to ensure their continued success
  • Know your customer, be able to identify the customer’s technical ability, and customize messaging to ensure the customer has a clear understanding of what is being conveyed to them
  • Anticipate follow-up questions and provide additional documentation to proactively answer ancillary questions or future issues
  • Be accountable for managing cases for key enterprise customers
  • Use company virtual machines and tools to replicate complex customer scenarios, confirm whether behavior is unique to Nintex and document all results into defined Nintex department
What we offer
What we offer
  • Global Gratitude and Recharge Days
  • Flexible, paid time off policy
  • Employee wellness programs and counseling resources
  • Meaningful peer recognition and awards
  • Paid parental leave
  • Invention/patenting assistance
  • Community impact, paid volunteer time, and opportunities
  • Intercultural learning and celebration
  • Multiple tools through which to learn and grow, and an incredible global community
  • Fulltime
Read More
Arrow Right

Managed Care Senior Manager

Corporate level manager responsible for deploying and contributing to strategic ...
Location
Location
United States , Fort Lauderdale
Salary
Salary:
Not provided
mhs.net Logo
Memorial Healthcare System
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelors
  • Five (5) years contracting experience with three (3) years contracting for hospital, professional services, ancillary facilities or specialty networks
Job Responsibility
Job Responsibility
  • Execute, contribute and manage complex legal, financial and operational contract language negotiations in concert with the Director of Managed Care or independently as applicable to the negotiation
  • Execute contracting strategies for all service lines in Memorial Hospitals, MHS employed physicians, transplant programs, and ancillary services of the fully integrated healthcare delivery system and its joint owned or joint ventured entities for fee for service and value based arrangements
  • Direct and analyze financial performance, reports and models, quality metrics and cost savings for negotiations with national and regional payors
  • Plan and monitor activities of staff and team members including hiring, orienting, training, mentoring, continuing education, evaluating, coaching and disciplinary actions
  • Enhance, estimate and preserve net revenues
  • Assure financial viability of contracts through financial analysis and forecasting in conjunction with Financial Analyst(s), contract negotiations and issue resolution
  • Execute strategies and guides operations to protect and build market share
  • Interface with managed care plans on claim reconciliations, trended issues and operational projects
  • Determine root cause and seek resolution
  • Evaluate payor assessments of overpayments and effectively dispute or resolve for settlement
  • Fulltime
Read More
Arrow Right

Managed Care Manager - Contracts

Corporate level manager responsible for deploying and contributing to strategic ...
Location
Location
Hollywood
Salary
Salary:
Not provided
mhs.net Logo
Memorial Healthcare System
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelors (Required)
  • 5 years contracting experience with 3 years contracting for hospital, professional services, ancillary facilities or specialty networks
Job Responsibility
Job Responsibility
  • Execute and manage legal, financial and operational contract language negotiations in concert with the Director of Managed Care
  • Contribute and coordinate negotiations of ancillary services in concert with the Director of Managed Care
  • Enhance, estimate and preserve net revenues and build market share
  • Escalate, monitor and manage operational issues from Managed Care Revenue Optimization, Accounts Receivable Management or Joint Operations
  • Address all single-case negotiations with non-contracted payors
  • Respond to insurance industry activities, healthcare reform, payer strategies, emerging market demands and legislative considerations
  • Fulltime
Read More
Arrow Right

Director - Managed Care

Corporate-level leader responsible for executing enterprise-wide strategic and t...
Location
Location
United States , Hollywood
Salary
Salary:
Not provided
mhs.net Logo
Memorial Healthcare System
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelors (Required)
  • 7 years managed care contracting experience with emphasis on facility contracting, preferably with local market knowledge
  • Payer and provider experience preferred
  • Requires critical thinking skills, effective communication skills, decisive judgment and the ability to work with minimal supervision
  • Must be able to work in a stressful environment and take appropriate action
  • Strong technical, financial and negotiation skills
  • Extensive managed care insurance and hospital industry knowledge
Job Responsibility
Job Responsibility
  • Enhance, estimate and preserve net revenues
  • Assures financial viability of contracts through financial analysis and forecasting in conjunction with Financial Analyst(s), contract negotiations and issue resolution
  • Execute strategies and guides operations to protect and build market share
  • Plan and monitor activities of staff and/or team members including hiring, orienting, training, mentoring, continuing education, evaluating, coaching & disciplinary actions, as applicable
  • Execute and manage complex legal, financial and operational contract language negotiations
  • Execute contracting strategy for all service lines in Memorial hospitals, Atlantic Coast Health Network (clinically integrated network), Memorial Health Network (clinically integrated network), MHS employed physicians, transplant programs (including subcontracting hospital-based groups), and ancillary services (ambulatory surgical centers, skilled nursing facility, rehabilitation facility, home health, home infusion, urgent care centers, sleep labs and other components) of the fully integrated healthcare delivery system, and its jointly-owned or joint-ventured entities for fee-for-service and value based agreements (capitation, bundled payments, pay for performance, shared savings, shared risk and full risk agreements)
  • Direct and analyze financial performance, reports and models, quality metrics and cost savings for negotiations with major national and regional payors
  • Monitor department operations, activities, resources to meet budget and goals
  • Respond to insurance industry activities, healthcare reform, payer strategies, emerging market demands, and legislative considerations and changes to the managed care industry to maintain a competitive position
  • Initiate and research new business opportunities (relationships, pricing, services, structures, operations, quality)
  • Fulltime
Read More
Arrow Right

Provider Contracting Advisor

The Provider Contracting Advisor serves as an integral member of the Provider Co...
Location
Location
United States of America , Columbus, OH
Salary
Salary:
92000.00 - 153300.00 USD / Year
thecignagroup.com Logo
The Cigna Group
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's Degree preferred. Industry experience will be considered in lieu of a degree. MBA or MHA preferred.
  • 3+ years Managed Care contracting and negotiating experience involving complex delivery systems and organizations required.
  • Experience in developing and managing key provider relationships
  • Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
  • Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners.
  • Intimate understanding and experience with hospital, managed care, and provider business models.
  • Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
  • The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations.
  • Customer centric and interpersonal skills are required.
  • Demonstrates an ability to maneuver effectively in a changing environment.
Job Responsibility
Job Responsibility
  • Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups).
  • Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
  • Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
  • Contributes to the development of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution.
  • Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
  • Creates and manages initiatives that improve total medical cost and quality.
  • Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
  • Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
  • Creates healthcare provider agreements that meet internal operational standards and external provider expectations. Ensures the accurate implementation, and administration through matrix partners.
  • Assists in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
What we offer
What we offer
  • Annual bonus plan.
  • Health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting day one.
  • 401(k)
  • Company paid life insurance
  • Tuition reimbursement
  • A minimum of 18 days of paid time off per year
  • Paid holidays.
Read More
Arrow Right