DSNP Account Manager (Columbus, Ohio)

Job Summary:

*To be eligible for this position, you must be located in the greater COLUMBUS, OHIO area. This position will be assigned that territory.*
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.
Essential Functions:

• 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.
• Keep management informed by documenting detailed activity and records of all agency/organization contacts in the Customer Relationship Management tool (“CRM”) and weekly reports.
• 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.
• 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.

Education and Experience:

• Bachelor's degree in Healthcare Administration, Nursing, Business, Public Health, or related field required
• Master's degree in relevant field preferred
• Equivalent years of relevant work experience may be accepted in lieu of required education
• 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

Competencies, Knowledge and Skills:

• Proven ability to collaborate with multidisciplinary teams across clinical and operational functions
• Strong knowledge of care coordination, benefits eligibility, enrollment processes, and health plan operations
• Ability to interpret and use healthcare data and performance metrics
• Familiarity with healthcare delivery models and provider network management
• In-depth knowledge of DSNP programs, Medicare Advantage, Medicaid, and long-term care services
• Understanding of clinical workflows, healthcare regulations, and compliance requirements relevant to Medicare and LTSS
• Proficient in Microsoft Office tools, including Project, Word, and Excel
• Advanced troubleshooting, critical thinking, and problem-solving capabilities
• Proven ability to effectively interact with all levels of management within the organization
• Flexibility during organizational and/or business changes
• Demonstrate excellent analysis and collaboration skills
• Demonstrate sense of urgency
• Ability to effectively and efficiently work within a team
• Exceptional written and verbal communication skills
• Strong interpersonal and relationship building skills
• Ability to work independently and within a team environment
• Ability to multi-task and prioritize work to meet project deadlines
• Critical listening and thinking skills
• Time management skills
• Customer service oriented
• Decision making/problem solving skills

Licensure and Certification:

• 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.
• Certification in account management, healthcare management, or case management (e.g., Certified Case Manager (CCM), Managed Care Professional (MCP) preferred
• Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated
• To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
• CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.

Working Conditions:

• This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential.
  Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time.
  Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need
  May be required to travel greater than 50% of time to perform work duties.
  Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer
  Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members
• Over 50% (Mobile) Routine travel required

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business