Contracts and Compliance Account Manager

2 months ago

Boise, Idaho, United States Magellan Health Full time
  • Overall oversight and management of client contract compliance, performance guarantee measurement and reporting.
  • Demonstrates contract understanding and detailed knowledge of business requirements.
  • Coordinates with Compliance and Legal departments on knowing and understanding regulations and the implication to customer impact and ensuring contract compliance.
Accountable for relationship building at multiple strategic customer touch points to include but not limited to day-to-day contacts, senior management, and key decision makers. May be directly or indirectly accountable to Profit and Loss of assigned account (s). Supports the development of ongoing strategy to ensure retention and growth by providing solutions that align with customers? overall business objectives. Develops strong relationships with internal matrix partners that support achievement of strategic alignment including operations (IT, Finance, Product Development, Claims, Legal etc.) and takes the leadership role in coordinating these resources to achieve business objectives, maintain account satisfaction, and ensure that the company's products and services support customer needs.
  • Manages customer Relationships.
  • Develops and maintains a strategic business plan that fully reflects the customer`s business objectives and how our solutions align with those objectives and goals and specifically guides our operational, financial, network, clinical and relationship initiatives.
  • Understands the customer structure and demonstrates the ability to apply this knowledge in business and retention planning for the client.
  • Ensures Service Level Agreement performance, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit analysis and adherence to requirements of the account's legal and regulatory environment.
  • Owns overall account satisfaction within the company as well as satisfaction with all specific areas particularly account management.
  • Develops strong relationships which penetrate the customer at various levels from day to day contacts to senior leadership involving other internal staff to maintain multiple connections and strengthen the overall relationship.
  • Develops strong relationships and contacts within the company that are supportive of the achievement of customer service requirements including attainment of performance guarantees and minimization of performance penalty expense.
  • Ensures all customer and account-facing services are provided in a consistent and timely fashion.
  • Supports the Internal Customer Operating Model.
  • Resolves or appropriately escalates customer service issues when escalated by the ASR in conjunction with operations (claims, service, and systems).
  • Provides mentoring to the account management team in effective problem solving and servicing of the account.
  • Develop, introduces, and executes the customer governance process.
  • Builds relationships and alliances with matrix partners.
  • Coordinates with the compliance department on knowing and understanding regulations and the implication to customer impact.
  • Oversees audit to ensure a proactive approach in supporting critical client compliance.
  • Proactive communication to internal and external contacts.
  • Demonstrates thorough contract understanding and detailed knowledge of business requirements.
  • Coordinates with legal to ensure contract compliance
  • Develops and executes contractual documents and amendments in conjunction with Finance and Legal.
  • Presents customer reports with meaningful analytics, trending and recommendations for program improvement based on findings and ensure coordination with the client.
  • Oversees reporting calendar to ensure timely submission.
  • Analyzes data and reporting and executive summary development.
  • Ensures all client reports have an executive summary and explanation of data.
  • Ensures revenue goals are met, cost of care and administrative expenses are managed and segment profit targets are achieved for assigned account (s).
  • Demonstrates a thorough knowledge of Cost of Care implications internally and for the client.
  • Ensures performance standards are measurable and realistic to achieve and/or exceed to avoid penalties. Partners with Operations and Network on monitors. Manages methodology, reporting and communications.
  • Directly participates and supports all renewal activities.
  • Manages risks and develop opportunities associated with underwriting.
  • Analyzes account and ability to apply this knowledge to growth.
  • Drives up-sell and renewal activities across assigned account(s).
  • For new business and renewals, negotiates and/or supports negotiation of rates and contractual terms with customers that result in achieving segment profit targets and creatively adjusts features and service delivery models that increase efficiency and improve value to the customer and/or margin for the company.
  • Where applicable, achieve objectives for regarding the EAP re-seller agreement.
  • Supports health plan with behavioral health retail sales.
  • Identifies products and services that bring solutions to the customer based on a thorough understanding of the customer's strategic business goals and the business needs.
  • Demonstrates depth of knowledge of the company's products and how multiple products are interdependent within the customer contract deliverables and outcomes.

Other Job Requirements

Responsibilities

12+ years' relevant experience.
Proficient in MS Office suite.
Excellent verbal and written communication skills.

General Job Information

Title

Contracts and Compliance Account Manager

Grade

29

Work Experience - Required

Account Management

Work Experience - Preferred

Education - Required

A Combination of Education and Work Experience May Be Considered., Bachelor's

Education - Preferred

Master's

License and Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum:

$93,955

Salary Maximum:

$159,725

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

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