Account Manager, ACOs & Medicare Supplement (MediGap) Health Plans

Ceresti Health

1d•Remote

About The Position

Ceresti Health is a tech-enabled dementia care provider pioneering a differentiated model of care to activate family caregivers by giving them the knowledge, skills, and confidence to detect an early change in their loved one’s condition. As one of the organizations selected by CMS to participate in the GUIDE Model and with almost a decade of experience working in Medicare Advantage populations, we’re at the forefront of transforming dementia care nationwide. The Account Manager, ACOs & MediGap is a high-ownership, relationship-intensive role at the intersection of performance management, physician awareness and education, carrier relationship development, and organizational change. You will serve as the primary partner for ACOs and Medicare Supplement carriers partnering with Ceresti — helping both ACOs and MediGap carriers strategically leverage the GUIDE Model to impact one of the costliest, most unmanaged cohorts in their populations. The Account Manager is responsible not just for account health, but for building the kind of trust that allows Ceresti to proactively enroll eligible beneficiaries on behalf of partner ACOs and MediGap plans. This is not a reactive account management role. ACOs are complex organizations with physician stakeholders who are protective of their patient relationships, operational teams managing competing priorities, and leadership who need to see ROI in shared savings and operational relief. MediGap carriers bring a different but equally complex dynamic — product and actuarial teams evaluating clinical value, compliance teams navigating CMS requirements, and member services teams that need seamless integration with GUIDE Model workflows. Your job is to earn and maintain trust across both channels — and to translate that trust into enrollment performance, program adoption, and measurable outcomes. You’ll succeed here if you’re energized by complexity, comfortable navigating physician skepticism and carrier procurement cycles, and deeply motivated by what it means to get this right for families living with dementia.

Requirements

Bachelor’s degree in a related field.
5+ years of experience in account management, client success, provider relations, carrier/payer relations, or partnership management within healthcare.
Experience working with ACOs, Medicare Advantage plans, Medicare Supplement (MediGap) carriers, or value-based care organizations. Direct experience with MediGap carriers, CMS care model delivery, or carrier product and operations teams is strongly valued.
Strong understanding of healthcare operations, provider workflows, and population health models.
Proven ability to manage complex, multi-stakeholder relationships.
Exceptional communication, organization, and follow-through skills.
Exceptional problem-solving skills.

Nice To Haves

Experience supporting CMS models (e.g. GUIDE, MSSP, ACO REACH, or other value-based programs).
Familiarity with caregiver support, dementia care, home care, or care management models.
Experience managing carrier or health plan accounts, including CMS model implementation, member engagement, or GUIDE-adjacent program delivery.
Experience presenting performance data and outcomes to executive audiences.
Comfort working in a high-growth, fast-moving startup environment.
Experience with HubSpot is a plus

Responsibilities

Serve as the primary account owner for assigned ACO and MediGap carrier partners from post-implementation through steady state.
Build strong, trusted relationships with ACO leadership, operations teams, clinical leaders, and care management staff, as well as MediGap carrier product, compliance, and member services teams.
Understand all components of the GUIDE Model and communicate GUIDE workflows to ACO care teams. For MediGap partners, understand how the GUIDE Model applies within the MediGap context and help carriers operationalize Ceresti's program for their member populations.
Act as an internal liaison at Ceresti for each partner (ACO or MediGap carrier), ensuring the partner’s needs, constraints, and priorities are clearly understood, communicated, and appropriately addressed.
Support contract adherence, shared savings alignment (ACOs), GUIDE Model performance targets (MediGap carriers), and ongoing partnership health.
Own enrollment performance for assigned ACOs and MediGap carriers, including monitoring physician/care team referral flow (ACOs), member outreach and program utilization (MediGap), outreach effectiveness, and caregiver activation.
Identify opportunities to improve uptake through provider education, workflow refinement, targeted engagement strategies, and — for MediGap partners — carrier marketing integration and member communications.
Partner with internal teams to troubleshoot enrollment barriers and optimize operational processes.
Support discussions around performance results, savings, and opportunities for expansion.
Drive physician awareness and buy-in across assigned ACO networks — including direct engagement with PCPs, care managers, and practice staff to establish Ceresti’s model as a trusted complement to existing care teams, not a competing intervention. For MediGap partners, enable carrier member services teams to support GUIDE Model enrollment and workflows for their members.
Coordinate patient-facing, provider-facing, and carrier-facing materials, training, and communications in collaboration with Marketing & Engagement teams.
Ensure providers understand Ceresti’s caregiver-centric approach and how it complements—not replaces—existing care management teams and efforts.
Build and maintain the trust and governance alignment required for Ceresti to conduct proactive outreach to eligible beneficiaries on behalf of partner ACOs and MediGap carriers. For ACOs, this means physician-level alignment; for MediGap carriers, this means carrier-approved member outreach and GUIDE Model enrollment workflows. Own the internal and external approvals, workflows, and communication protocols that make proactive enrollment operationally viable and clinically credible across both channels.
Coordinate closely with Implementation, GUIDE Coordinators, Coaching, and Operations teams to ensure smooth ongoing operations across ACO and MediGap accounts.
Support data-sharing workflows, CCLF data file refreshes (ACOs), carrier eligibility file exchanges (MediGap), and outreach approvals in alignment with ACO governance and carrier compliance requirements.
Monitor operational SLAs, outreach cadence, and member experience to ensure a high-quality, compliant program.
Lead recurring partner check-ins and business reviews with assigned ACOs and MediGap carriers.
Deliver clear, data-driven updates on enrollment, engagement, outcomes, and operational performance.
Translate complex data into concise, executive-ready insights for ACO and MediGap carrier stakeholders.