Role Overview: The primary responsibility of Account Executive is to develop strong relationships with providers to drive for performance, specifically as it relates to core providers as determined by the program who are in fee for service programs and may include PCPs, OB/GYNs, high volume specialists, and FQHCs.
Work Arrangement:
- Remote – This position is fully remote. The Associate must visit provider offices and attend in-person meetings at our Delaware (DE) office.
Responsibilities:
- Supports network development and network management strategies.
- Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication.
- Assist in SCA Strategy.
- Responsible for building, nurturing, and maintaining positive working relationships between Plan and its contracted providers.
- Resolve Provider disputes in a timely and compliant manner.
- Servicing assigned provider accounts which may include single or multiple practices in single or multiple locations, integrated delivery systems or other provider organizations.
- Uses data to develop and implement methods to improve relationship.
- Perform site visits as needed.
- Maintains a functional working knowledge of provider database and routinely relays information about additions, deletions or corrections.
- Identifies and maintains strong partnerships with appropriate internal resources and stakeholders.
- General Operational Knowledge related to provider satisfaction, education and communication with a fundamental understanding of operational items such as claims, payment integrity, provider data, credentialing, appeals disputes etc.
- Maintains in depth understanding of Plan’s contracts and provider performance and needs, identifying, and conducting relevant and tailored provider orientation sessions, making educational visits and working to resolve provider issues.
- Assist with recruiting providers based on identified network adequacy gaps (high complexity).
- Support contracting for multiple product lines, including LTSS, Exchange, DSNP could be asked to complete straightforward FFS contracts.
- Support of VBC relationships and negotiations where needed.
Education & Experience:
- Bachelor's degree.
- 1 or more years of strong communication skills.
- Would need to deliver provider education, training, and onboarding to large groups.
Licensure:
- Valid driver's license, care insurance, and reliable transportation.
