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The Network Account Manager represents and advances Healthfirst interests in the Provider market as the preferred and ultimately preeminent plan through superior customer service and execution of Provider engagement strategies. The Network Account Manager represents commitment to developing and managing a high performance network and to engaging in various Provider engagement strategies that follow four core principles: Quality, Clinical Efficiency, Administrative Efficiency and Population Health.
Job Responsibility:
Serve as plan liaison for physicians/physician groups in a specified geographical area
Responsible for the resolution of all issues
Responsible for the provider recruitment process
Schedule frequent and regular face-to-face contact with the practice locations
Keep abreast of competitor activity
Conduct new provider orientation and identify opportunities for education
Responsible for monitoring and reporting on providers' clinical quality & financial performance
Handle other duties as assigned with the occasional need to work weekends, overtime and/or travel throughout the tristate area
Requirements:
High School Diploma or GED Equivalent
Medicare and/or Medicaid managed care experience
Excellent oral and written communication skills (Letter writing, Memo, and Email)
Nice to have:
Bachelor’s Degree from an accredited institution
Active driver license and access to a vehicle
Provider office operations experience
Ability to understand Provider 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