Account Executive

Job Summary

The primary responsibility of Account Executive is to develop strong relationships with providers to drive performance, specifically as it relates to core providers as determined by the program who are in fee for service programs and may include PCPs, OB/GYNs, high volume specialists, and FQHCs.

Essential Functions

• Supports network development and network management strategies.
• Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication.
• Aid in SCA Strategy.
• Build, nurture, and maintain 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 relationship.
• 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.
• Aid in VBC relationships and negotiations where needed.

Education/Experience

• Associate Degree Required
• Bachelor Degree Preferred
• One (1) or more years strong communications skills, would need to deliver provider education, training, and onboarding to large groups.

Work Arrangement

This position is a remote field based position in South Carolina. Will be required to make provider visits within South Carolina regions.

Comprehensive Benefits Package

• Flexible work solutions including remote options, hybrid work schedules
• Competitive pay
• Paid time off including holidays and volunteer events
• Health insurance coverage for you and your dependents on Day 1
• 401(k)
• Tuition reimbursement
• and more.