Full-Time Senior Account Manager

The Senior Account Manager is accountable for overall performance and profitability for their assigned provider groups and/or financial pools.
If you are located in Southeast Kansas or Southwest Missouri you will have the flexibility to work remotely* as you take on some tough challenges

Primary Responsibilities:

• Analyze risk pool and/or provider group performance to determine areas of focus or improvement opportunities, to include performing analysis of financial statements and other metric-related report to determine areas of focus or improvement opportunities
• Develops strategies and create action plans that align provider pools and groups with company initiatives, goals (revenue and expense) and quality outcomes
• Drive processes and improvement initiatives that directly impact revenue, HEDIS/STAR measures and quality metrics, coding and documentation process and educational improvements
• Use and analyze data to identify trends, patterns and opportunities for the business and clients, and collaborating and/or participating in discussions with colleagues and business partners to identify potential root cause of issues
• Collaborates with internal clinical services teams, alongside Client Services leaders, to monitor utilization trends and risk pools to assist with developing strategic plans to improve performance.
• Assists provider groups with investigating standard and non-standard requests and problems, to include claims and member support services
• Maintains effective support services by working effectively with the Director of Client Services, Regional Medical Director, Clinical Services team, Operations and other corporate departments
• Demonstrate understanding of providers' business goals and strategies in order to facilitate the analysis and resolution of their issues
• Performs all other related duties as assigned

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 3+ years of experience in a related medical field or health plan setting (network management, contracting and/or recruitment, or provider relations)
• Experience interfacing effectively internally with all levels of staff and externally with a wide range of people such as physicians, office staff, hospital executives, medical groups, IPA's, and community organizations; Ability to communicate and facilitate strategic meetings with groups of all sizes
• Working knowledge of Medicare health care operations including HEDIS, CMS reimbursement models, and Medicare Advantage
• Knowledge of state and federal laws relating to Medicare
• Proficiency in Microsoft Word, Excel and PowerPoint
• Ability and willingness to travel, both locally and non-locally, as determined by business need

Preferred Qualifications:

• Healthcare management experience
• Proven solid business acumen, analytical, critical thinking and persuasion skills
• Proven ability to act as a mentor to others
• Proven ability to develop long-term positive working relationships
• Proven ability to work independently, use good judgment and decision-making process
• Proven ability to conduct performance evaluation to identify performance measures or indicators and the actions needed to improve or correct performance, relative to the goals