Network Account Manager
HealthFirst
Summary
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 description
- Serve as plan liaison for physicians/physician groups in a specified geographical area. Will be main point of contact for all plan-related issues including marketing, enrollment, contracting, billing and reimbursement. Responsibility for the resolution of all issues, including those identified by the provider, and those identified internally that have an impact on the physician. Coordinates with all Healthfirst staff to assist as appropriate, including creating project plans, issue logs, conference calls, etc.
- Responsibility for the provider recruitment process. Identify gaps, complete paperwork, etc.
- Schedule frequent and regular face-to-face contact with the practice locations 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 based on market trends.
- Conduct new provider orientation and identify on an ongoing basis 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' 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 tri-state area. Engage in mastering the Division's impact on Healthfirst, its Members and Providers
Requirements
- High School Diploma or GED from an accredited institution
- Bilingual fluency (reading, writing, speaking) Spanish and English
- Medicare and/or Medicaid managed care experience
- Experience with MHS, Macess, and/or electronic archiving
- Provider office operations experience
- Ability to understand Provider claims reimbursement
- Contract negotiation experience
- Professional Writing skills (Letter writing, Memo and Email)
- Excellent oral and written communication skills
Benefits
- Medical, Dental & Vision
- Incentive & Recognition Programs
- Life Insurance
- 401(k) Contributions
Company overview
HealthFirst is a medical equipment manufacturing company specializing in the development and production of healthcare devices and diagnostic equipment. As a medical device manufacturer, the company focuses on creating innovative solutions that enhance patient care and improve clinical outcomes. HealthFirst operates in the competitive medical technology sector, where it likely develops products ranging from diagnostic instruments to therapeutic devices used in various healthcare settings. The company's commitment to quality and regulatory compliance positions it as a reliable provider of medical equipment to hospitals, clinics, and healthcare facilities. With expertise in medical device engineering and manufacturing, HealthFirst contributes to advancing healthcare technology while maintaining rigorous standards for safety and efficacy. The company's products are designed to meet the evolving needs of healthcare professionals and patients, supporting improved diagnosis, treatment, and monitoring of medical conditions across different therapeutic areas.