Account Executive

Amerihealth Caritas•Asheville, NC

4d•Hybrid

About The Position

As an Account Representative for AmeriHealth Caritas North Carolina, you will 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. Examples of providers you will work with include and may include Primary Care Physicians, OB/GYNs, high volume specialists, and Federally Qualified Health Centers (FQHC). Qualified candidates must reside in North Carolina and be local to Asheville. Monday through Friday, 8:30 AM to 5:00 PM

Requirements

High School Diploma or GED required
Minimum of three years of experience in provider relations
Experience delivering provider education, training, and onboarding to large groups
Ability to cultivate and maintain relationships with internal resources and external stakeholders
Proficiency in MS Office
Working knowledge of provider databases and ability to analyze the data in order to develop and implement methods to improve relationships with providers
Strong communication skills with the ability to influence stakeholders in order to create mutually beneficial agreements
Ability to navigate complex contractual terms and conditions

Nice To Haves

Bachelor’s Degree preferred

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 relationships with providers
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 Value Based Care relationships and negotiations where needed.