The Manager, Network Account Management will lead an interdepartmental Account Team and apply in-depth account knowledge to strategize, develop and implement integrated strategies with high priority providers focused on strengthening provider engagement, enhancing quality and optimizing membership growth and profitability. This role will develop deep and effective provider relationships to support administrative ease and enhance the Healthfirst reputation as a “trusted partner”.
- Develop trusting and long-term relationships with all key decision makers/influencers, including senior leaders and physicians
- Local provider market knowledge and expertise with deep understanding of customer and provider needs
- Claims troubleshooting
- Leads the strategic planning and contracting process at the provider levels and supports the team in execution at the account level.
- Leads the interdepartmental strategic planning process at Healthfirst to develop and implement strategic action plans
- Drive profitable growth through leading the creation of customized winning solutions
- Work with Sales, Marketing, Operations, Clinical partnerships, Legal and other internal stakeholders to align resources and deliver on the business and clinical vision.
- Coordinate/leverage internal resources appropriately to promote administrative ease
- Negotiate provider agreements that support achievement of Healthfirst strategic goals
- Translate strategic goals into provider specific plans and activities.
- Understand emerging trends, network/market opportunities and competitive threats
- Understand Healthfirst products and how they provide benefit to customers.
- Partner with providers as they evolve.
- Support various project implementation and complete additional administrative duties as applicable
Minimum Qualifications:
- Experience in leading a team through a matrixed environment
- Experience in provider network management and development, or project management experience in a managed healthcare setting
- Experience in negotiating different provider contract types (physician, groups and ancillary providers)
- Familiarity with various provider compensation methodologies across Medicaid and Medicare lines of business for different provider types
- Experience working with an executive suite
- Exposure to multiple functions especially finance, business intelligence
- Bachelor’s Degree
Preferred Qualifications:
- MBA in Business and Health Services
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
EEO Law Poster and Supplement
All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.
Hiring Range*:
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Greater New York City Area (NY, NJ, CT residents): $100,900 - $145,775
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All Other Locations (within approved locations): $86,500 - $128,690
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.
What We Do
Healthfirst is a provider-sponsored health insurance company that serves 1.8 million members in downstate New York. Healthfirst offers top-quality Medicaid, Medicare Advantage, Child Health Plus, and Managed Long Term Care plans. Healthfirst Leaf Qualified Health Plans and the Healthfirst Essential Plan are offered on NY State of Health, The Official Health Plan Marketplace. Healthfirst offers Healthfirst Pro and Pro Plus, Exclusive Provider Organization (EPO) plans for small-business owners and their employees, and Healthfirst Total, an EPO for individuals.
For more information on Healthfirst, visit www.healthfirst.org