Managed Care Account Manager

Essential Functions

• Provides daily administrative and client service support to Producers, Account Executives, and managed care clients within reinsurance and provider stop-loss programs.
• Gathers, reviews, and prepares renewal data including claims experience, large claimant reports, premium and rate history, and exposure information.
• Supports a Middle Market book consisting of managed care, provider stop-loss, and reinsurance programs; experience in these areas is highly preferred.
• Processes policy changes, renewals, and documentation including binders, confirmations of coverage, and program summaries.
• Affords assistance to clients with claims reporting and coordinates with carriers, TPAs, and internal teams throughout the lifecycle of claims.
• Ensures that all assigned transactions are executed accurately and in a timely manner with documentation maintained to standards.
• Maintains client communication to ensure understanding of program structure, coverage, and obligations.
• Invoices accounts and assists with tracking receivables and premium payments where required.
• Prepares renewal strategy materials and identifies opportunities for program enhancements.
• Works renewal timelines to support retention and client satisfaction.
• Maintains accurate client data within agency systems in accordance with procedures.

Competencies & Qualifications

• Ability to analyze complex managed care, reinsurance, and stop-loss arrangements and communicate clearly.
• Familiarity with provider contracting.
• An understanding of CMS alternative capitated payment model.
• Understanding of capitated payment models.
• Ability to work independently with limited supervision.
• Strong organizational skills with the ability to manage multiple priorities.
• Advanced proficiency in Microsoft Excel is required, strong working knowledge of Word and PowerPoint.
• Strong verbal and written communication skills.
• High attention to detail and accuracy.
• Ability to collaborate effectively with clients, carriers, TPAs, and internal teams.
• Demonstrates a client-first approach.

Education & Experience

• Minimum of 4 years of related experience in managed care, reinsurance, or provider stop-loss.
• Knowledge of EPIC or similar agency management system preferred.
• High school diploma required; college degree preferred.
• Accident & Health insurance license is suitable or Property & Casualty License.