NY, USA
16 days ago
Network Account Manager (Contracting Specialist)
Description and Requirements The Network Account Manager represents and advances Healthfirst interests in the Provider/Vendor market as the preferred and ultimately preeminent plan through superior customer service and execution of Provider/Vendor engagement strategies. The Network Account Manager represents commitment to developing and managing a high-performance network and to engaging in various Provider/Vendor engagement strategies that follow four core principles: Quality, Clinical Efficiency, Administrative Efficiency and Population Health. Serve as plan liaison for vendors/physicians/physician groups in a specified geographical area. Will be the main point of contact for all plan related issues including marketing, enrollment, contracting, billing and reimbursement.Responsible for the resolution of all issues, including those identified by the provider/vendor, and those identified internally that have an impact on the physician/vendor. Coordinates with all Healthfirst staff to assist as appropriate, including creating project plans, issue logs, conference calls, etc.Responsible for the provider/vendor recruitment process. Identify gaps, complete paperwork, etc.Schedule frequent and regular face-to-face contact with the practice locations/vendors 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/vendors based on market trends.Conduct new provider/vendor orientation and identify 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/vendors' 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 tristate area. Engage in mastering the Division's impact on Healthfirst, its Members, and Providers

Minimum Qualifications:

Associate’s degree from an accredited institution or sufficient years of experienceMedicare and/or Medicaid managed care experienceExcellent oral and written communication skills (Letter writing, Memo, and Email)

Preferred Qualifications:

Bachelor’s Degree from an accredited institutionProvider office operations experienceAbility to understand Provider/vendor claims reimbursementContract negotiation experienceBilingual fluency (reading, writing, speaking) Chinese or Spanish and EnglishExposure to multiple functions especially finance, business intelligenceExperience with Microsoft office such as Excel, Outlook, and/or electronic archiving

Hiring Range*:

Greater New York City Area (NY, NJ, CT residents): $67,200 - $97,155

All Other Locations (within approved locations): $59,800 - $88,910

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

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