Network Account Manager Contracting Specialist
Network Account Manager Contracting Specialist
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$ 59800 - 88910
1 Vacancy
Job Description
- Serve as plan liaison for 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 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.
- Responsible for the provider recruitment process. Identify gaps complete paperwork etc.
- Schedule frequent and regular facetoface 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 opportunities for education on both clinical and administrative topics. Includes experts in the field of education as needed from inhouse 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 tristate area. Engage in mastering the Divisions impact on Healthfirst its Members and Providers
Minimum Qualifications:
- Medicare and/or Medicaid managed care experience
- Excellent oral and written communication skills (Letter writing Memo and Email)
Preferred Qualifications:
- Associates 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
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race color religion gender gender identity sexual orientation national origin age genetic information military or veteran status marital status mental or physical disability or any other protected Federal State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment please contact us by sending an email to or calling. In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the email address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
All hiring and recruitment at Healthfirst is transacted with a valid @healthfirst email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst or not one of our recruitment partners please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.
Hiring Range*:
Greater New York City Area (NY NJ CT residents): $67200 $97155
All Other Locations (within approved locations): $59800 $88910
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.
Required Experience:
Manager
Employment Type
Full-Time
