Senior Account Executive

About the role

AmeriHealth Caritas is seeking talented, passionate individuals to join our team. We are a mission-driven organization with more than 30 years of experience delivering comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Job Summary

The primary responsibility of Account Executive Sr. is to develop strong relationships with providers to drive for performance specifically as it relates to core providers who are on risk-based or cost sharing VBC arrangements as well as large health system contracts.

Responsibilities

• Supports network development and network management strategies.
• Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication.
• Participates and implements Provider Network education programs and materials (both internal and provider targeted).
• Builds, nurtures, and maintains positive working relationships between Plan and its contracted providers.
• Develops/implements/manage programs and projects that support/impact high dollar and high member provider groups.
• Oversees resolution of provider issues managed by other Provider Network support teams.
• Takes corrective actions required up to and including termination, following Plan policies and procedures.
• Operationalizes completed contracts with advanced complexity.
• Consults on VBC contracts, facilitates for success (JOCs, performance overview, etc.) with specific bonuses attached to performance improvement.
• Maintains and manages Value-Based contract requirements, including but not limited to; monitoring performance standards against VBC or State program requirements, working with key stakeholders, and providing oversight on applicable data-sharing or report requirements.
• Responsible for hospital and physician network development and management; including joint operating committees (JOC) for identified groups, oversight of necessary quality review meetings with targeted providers and/or health systems.
• Supports contracting for multiple product lines, including LTSS, Exchange, DSNP adequacy gaps (high complexity).
• Assists with recruiting providers based on identified network adequacy gaps (high complexity).
• Supports VBC negotiations; lead in VBC relationships; may lead negotiations.

Requirements

• Associate’s Degree required or 5+ years as an Account Executive.
• Bachelor's Degree preferred.
• Preferred Experience Level (if different from minimum required): Seven years’ experience if no bachelor’s degree, 7 years experience if no bachelor's degree.
• Five (5) or more years strong communication skills, financial acumen, ability to have difficult conversations.

Qualifications

• Minimum bandwidth of 50 Mbps download and 5 Mbps upload is required for remote associates.
• Must reside in Louisiana for hybrid positions.

Benefits

Our Comprehensive Benefits Package includes 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.