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Network Account Manager (Contracting Specialist)

3+ months ago New York, NY

This job is no longer available.

Description and Requirements

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.

  • 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 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 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 tristate area. Engage in mastering the Division's impact on Healthfirst, its Members, and Providers

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Minimum Qualifications:

  • High School Diploma or GED equivalent
  • Contract negotiation experience
  • Medicare and/or Medicaid managed care experience
  • Excellent oral and written communication skills (Letter writing, Memo, and Email)

Preferred Qualifications:

  • Bachelors Degree from an accredited institution
  • Active driver license and access to a vehicle
  • Provider office operations experience
  • Ability to understand Provider claims reimbursement
  • 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

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.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

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 careers@Healthfirst.org or calling 212-519-1798 . 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 HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC.

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Client-provided location(s): New York, NY
Job ID: healthfirst-R017307
Employment Type: OTHER
Posted: 2024-10-17T12:29:57

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Health Reimbursement Account
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • Short-Term Disability
    • Long-Term Disability
    • FSA
    • HSA
    • Fitness Subsidies
    • Mental Health Benefits
    • Pet Insurance
  • Parental Benefits

    • Birth Parent or Maternity Leave
    • Family Support Resources
  • Work Flexibility

    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Office Life and Perks

    • Commuter Benefits Program
    • Casual Dress
    • Happy Hours
    • Company Outings
    • Holiday Events
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
    • Volunteer Time Off
  • Financial and Retirement

    • 401(K) With Company Matching
    • Performance Bonus
  • Professional Development

    • Internship Program
    • Tuition Reimbursement
    • Promote From Within
    • Access to Online Courses
    • Lunch and Learns
    • Associate or Rotational Training Program
    • Learning and Development Stipend
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Woman founded/led
    • Diversity, Equity, and Inclusion Program

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