Senior Network Account Manager

• Advance Healthfirst through superior customer service focused leadership in an assigned territory and team, which will help to optimize provider satisfaction
• Educate and train network representatives in key business principles around profitability, network adequacy, quality, etc.
• Promote successful internal collaboration within Healthfirst for our providers
• Manage projects
• Provides coaching/mentoring for staff
• Identifies improvement for further training/education
• Critical thinking that solves problems with a logical, analytical discipline with a view on how decisions may impact provider/practice operations
• Understanding of various reimbursement methodologies as it relates to the community provider network
• Strong grounding of core principles and the role of hospitals within both Clinical Efficiency, Population Health, and Administrative Efficiency
• Proactively identify trends of issues, root causes and their magnitude, develop and implement action plans to closure
• Ability to review and draw conclusions from reports that integrate job knowledge and practical applications that answer or respond to a question or issue or may lead to other issues
• Fiscal understanding of reimbursement and utilization practices
• Ability to analyze reports related to provider performance and relate provider practice patterns to overall trends
• Negotiation skills which clearly allow for ranges of discussions with a clear line of escalation when necessary as well as presentation for approval from Senior Management
• Regulatory/ Legal understanding of the contracting logistics
• Solid understanding of terms of contracts and how they should be applied: financial, amendment, termination, etc.
• Understanding and ability to guide translation of contract terms into system rules, i.e., configuration, creation or amendment of new provider records and knowledgeable review to ensure accuracy of future claims
• Ability to guide and facilitate the team's contracting process from start to finish

• Medicare and/or Medicaid managed care experience
• Provider office operations experience
• Ability to understand provider claims reimbursement
• Contract negotiation experience
• Professional writing skills (Letter writing, Memo and Email)

Bachelor's degree

• medical, dental and vision coverage
• incentive and recognition programs
• life insurance
• 401k contributions