Managed Care Account Manager

About the role

Collaborates with the team to consistently deliver high-quality service to managed care clients with a focus on reinsurance and provider stop-loss programs. Ensures service standards including execution, delivery, and retention are achieved. Provides efficient, professional, and courteous service to clients by phone, in writing, and in person. The role is responsible and accountable for risk by openly exchanging ideas and opinions, elevating concerns, and personally following policies and procedures as defined. Accountable for always doing the right thing for customers and colleagues and ensures that actions and behaviors drive a positive customer experience.

Responsibilities

• 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.
• Assists 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.

Requirements

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

Skills

• Ability to analyze complex managed care, reinsurance, and stop-loss arrangements and communicate clearly.
• Familiarity with provider contracting.
• Understanding of CMS alternative capitated payment model and 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.

Benefits

• Comprehensive range of health-related benefit options including medical, vision, and dental.
• 401(k) with company match.
• Company paid life insurance, short-term disability (STD), and long-term disability (LTD).
• Generous PTO policy starting at 18 days per year plus 10 paid holidays and 2 floating holidays.