DSNP Account Manager (CLEVELAND, OHIO)

CareSource•Cleveland, OH

1d•$83,000 - $132,800•Remote

About The Position

The DSNP Account Manager serves as the primary field-based liaison between the organization and DSNP‑participating providers, nursing facilities, and long‑term care partners, acting as the local subject matter expert for DSNP programs. This role builds trusted provider relationships through regular on‑site engagement, education, and issue resolution while identifying operational, clinical, and administrative barriers impacting DSNP members to drive program alignment, improve provider experience and member outcomes, and inform DSNP product and operational strategy through structured field feedback.

Requirements

Bachelor's degree in Healthcare Administration, Nursing, Business, Public Health, or related field required
Five (5) years experience in healthcare account management, provider relations, case management, or related roles within Medicare, Medicaid, or managed care environments required
Experience conducting onsite provider visits and delivering provider education required
experience working with Dual Eligible Special Needs Plans (DSNP), Medicare Advantage, or long-term care providers required
Current, unrestricted State Insurance License in Accident and Health required, or ability to obtain within 30 days of hire and annual recertification each year thereafter is required.
Must have valid driver's license, vehicle and verifiable insurance.
Influenza vaccination is a requirement of this position.
Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need

Nice To Haves

Master's degree in relevant field preferred
Equivalent years of relevant work experience may be accepted in lieu of required education
Certification in account management, healthcare management, or case management (e.g., Certified Case Manager (CCM), Managed Care Professional (MCP) preferred

Responsibilities

Serves as the primary field-based liaison between the organization and DSNP-participating providers, nursing facilities, and long-term care partners.
Builds and maintains strong, trusted relationships with facility leadership, administrators, and clinical staff to support DSNP program success.
Conducts regular on-site visits to nursing facilities and provider offices to support education, issue resolution, and operational alignment.
Acts as the local DSNP subject matter expert for providers, addressing questions related to benefits, eligibility, enrollment, and care coordination.
Identifies operational, clinical, or administrative barriers impacting DSNP members and works cross-functionally to drive timely resolution.
Keep management informed by documenting detailed activity and records of all agency/organization contacts in the Customer Relationship Management tool (“CRM”) and weekly reports
Supports onboarding and ongoing engagement of DSNP-participating facilities, ensuring understanding of program requirements and workflows.
Collaborates with internal Clinical, LTSS, Operations, and Network teams to improve member outcomes and provider experience.
Monitors provider performance indicators and escalates risks or trends that may impact quality, access, or compliance.
Provides feedback from the field to inform DSNP product design, operational improvements, and network strategy.
Documents provider interactions, issues, and follow-ups to ensure visibility, accountability, and continuity across teams.
Perform any other job related duties as requested.