Licensed Account Manager

About the Role

This position of Licensed Account Manager is a field-based role which reports to the Market Vice President and whose major focus is to support the member care delivery system and skilled nursing facility partners in providing high quality patient-centered care for I-SNP members.

Responsibilities

• Coordinate all plan functions related to assigned facilities and lead the joint team effort of delivering high quality and cost-effective program of care in conjunction with facility, plan, corporate staff, and management
• Serve as the main point of contact between facility and plan; collaborate with facility management and staff to ensure quality services are provided to members and plan administrative functions are carried out effectively
• Maintain a regular visit schedule for assigned SNFs, visiting each at least monthly and ensuring ongoing communication with all relevant SNF leaders and LHP champion
• Manage SNF contractual relationships and ensure accurate administration of contract terms
• Lead and participate in multidisciplinary teams comprised of contracted provider representatives
• Identify and resolve operational issues between plan and facility and coordinate implementation of solutions to ensure positive long-term working relationship
• Provide ongoing intervention and assistance in the management of contracting, claim payment, facility and provider credentialing, requests for records or data review related to HEDIS or other reporting needs or audits as required
• Complete monthly data reviews and present educational/best practice topics at cross functional meetings with SNF leadership team
• Together with Market VP, establish facility specific strategy and enrollment goals then enact strategy within assigned facilities
• Identify key providers and support contracting efforts by developing relationships with IPAs, hospitals, and key specialty services
• Lead the implementation of I-SNP participating providers in their region and ensure that all assigned participating nursing facility and related providers are prepared to offer Longevity ISNP program
• Verify each facility is prepared to successfully launch I-SNP according to schedule and oversee all aspects of a compliant ISNP program at the facility
• Ensure correct/complete member records within various LHP utilized systems
• Regularly document market-based efforts and current partner interactions, barriers, action plans, etc. to drive increased engagement and high levels of I-SNP penetration
• Assist in the development of materials and present as needed during Monthly Operating Review meetings, Business Development meetings and partner-facing Joint Operating Committee meetings
• Participate in weekly market/clinical team call and monthly clinical-focused meeting
• Ensure contract compliance with all requirements as set forth by State and Federal agencies
• Define and develop sales opportunities within assigned territory
• Educate Skilled Nursing Facility personnel on Longevity Health Plan benefits, as well as compliant lead generation
• Generate leads through education, relationships and ongoing SNF census reviews
• Conduct benefit presentations with potential members, family members or Responsible Parties
• Complete daily lead management and required documentation
• Ensure timely and accurate application processing
• Participate in Sales-focused meetings and coordinate with Regional Sales Manager for ongoing job training and support
• Ensure, enforce, and support organization's strict adherence to the Company's Compliance Plan and Standards of Conduct

Requirements

• License to sell Medicare—Health Insurance Producer License, required prior to hire date
• Valid state driver’s license with a good driving record and proof of automobile insurance required
• Auto liability insurance declaration page with minimum limits of $100,000/$300,000 for bodily injury and $100,000 for property damage with combined single limit of $300,000
• Bachelor’s degree preferred
• Relevant Work Experience: 3 plus years of healthcare industry experience with focus on provider relations, contracting, and business development
• Minimum 2 years of sales experience
• Excellent communication and presentation skills to all levels of staff and management
• Strong written and verbal communication skills
• Strong project management and coordination skills
• Ability to understand complex and comprehensive contractual arrangements
• Proficiency in computer skills and Microsoft Office Suite products
• Comfortable working in a Skilled Nursing Home environment

Qualifications

The ideal candidate will have a strong background in healthcare, sales, and account management, with excellent communication and presentation skills.

Skills

• Strong communication and presentation skills
• Ability to work in a fast-paced environment
• Strong project management and coordination skills
• Ability to understand complex contractual arrangements
• Proficiency in computer skills and Microsoft Office Suite products