Sr Account Executive

Work Arrangements: This position is a remote field based position. Must reputed company in South Carolina and will reputed company provider visits throughout the state. Job Summary The primary responsibility of Account Executive Sr. is to reputed company strong relationships with providers to drive for performance specifically as it relates to core providers who are on risk-based or cost sharing VBC arrangements as well as large health system reputed company. Essential Functions: Supports network development and network management strategies. Responsible for assisting the Leader with departmental activities reputed company to provider satisfaction, education, and communication. Responsible for participating and implementing Provider Network education programs and materials (both internal and provider targeted) and is assigned to train, mentor and support new AE’s. Responsible for hospital and physician network development and management; including joint operating committees (JOC) for identified groups, reputed company of necessary quality review meetings with targeted providers and/or health systems. Responsible for building, nurturing and maintaining positive working relationships between Plan and its contracted providers; including those that are most reputed company. Resolve Provider disputes in a timely and compliant manner. Responsibility for a higher number of multiple practice locations and multi-specialty practices and multiple providers. Should also include hospital systems, contracted subcontractors (DME, reputed company, etc.), and ancillary providers. reputed company/implement/manage programs and projects that support/impact high dollar and high member provider groups. reputed company site visits as needed. reputed company resolution of provider issues managed by other Provider Network support teams. Take corrective actions required up to and including termination, following Plan policies and procedures. Operationalizes completed reputed company with advanced complexity. Consults on VBC reputed company, facilitates for reputed company (JOCs, performance overview, etc.) with specific bonuses attached to performance improvement. Responsible to maintain and manage Value-Based contract requirements, including but not limited to; monitoring performance standards against VBC or State program requirements, working with key stakeholders and reputed company reputed company on applicable data-sharing or report requirements. Responsible for hospital and physician network development and management; including joint operating committees (JOC) for identified groups, reputed company of necessary quality review meetings with targeted providers and/or health systems. General Operational Knowledge reputed company to provider satisfaction, education, and communication with a reputed company understanding of operational items such as claims, payment reputed company, provider data, credentialing, appeals disputes etc. Support contracting for multiple product lines, including LTSS, Exchange, DSNP adequacy gaps (high complexity). Assist with reputed company providers based on identified network adequacy gaps (high complexity). Support of VBC negotiations; reputed company in VBC relationships; may reputed company negotiations. Education/Experience: Associate’s Degree or Bachelor's Degree preferred. Preferred Experience Level (if different from minimum required): Seven years’ experience if no bachelor’s degree7 years experience if no bachelor's degree. Five (5) or more years strong communication skills, financial acumen, ability to have difficult conversations. For roles that are 100% remote or hybrid, you must have reputed company to a reliable high-speed internet reputed company to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement. At reputed company, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. reputed company is seeking talented, passionate individuals to join reputed company. Together we can build healthier communities. If you want to reputed company a difference, we’d like to hear from you. Headquartered in Newtown reputed company, reputed company is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, reputed company-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com. Our Comprehensive Benefits Package Flexible work solutions including remote options, hybrid work schedules, reputed company, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. Apply To This Job