Behavioral Health Provider Network Account Executive

1 month ago

Washington DC USA, United States Enlightened Full time
Job Title: Behavioral Health Provider Network Account Executive

The Behavioral Health Provider Network Account Executive plays a critical role in building and maintaining strong relationships between our organization and its contracted Behavioral Health providers. This position requires a deep understanding of our contracts and provider performance, as well as the ability to identify and develop tailored solutions to meet the needs of our providers.

Key Responsibilities:
  • Develop and maintain in-depth knowledge of our contracts and provider performance
  • Identify and develop tailored solutions to meet the needs of our providers
  • Build and maintain strong relationships with our providers
  • Monitor and manage our provider network to ensure access to services throughout our territory
  • Identify, contact, and solicit qualified providers to participate in our network
  • Assist in corrective actions required up to and including termination, following our policies and procedures
  • Support the Quality Management department with credentialing and re-credentialing processes, investigation of member complaints, and potential quality issues
Requirements:
  • Experience working with Behavioral Health providers required
  • Bachelor's Degree
  • 3 to 5 years' experience in a Provider Services position working with Behavioral Health providers
  • 5 to 10 years' experience in the managed care/health insurance industry with demonstrated strengths in knowledge of Plan policies and procedures related to provider contracting, provider credentialing, provider billing and payment, provider incentive programs, and other key State and Federal regulatory requirements
  • Substantive Account Executive experience with high impact, high dollar, extremely visible and critical provider groups
  • Medicaid experience required
  • Strong leadership skills and ability to navigate change
  • Ability to work cross-functionally, problem solve, and navigate efficiently through bureaucracy
  • Working knowledge and proficiency with Microsoft Office products
  • Ability to manipulate spreadsheets and data in Microsoft Excel
  • Excellent listening skills
  • Strong verbal and written communication skills
  • Detailed oriented with strong organizational and time management skills
  • Self-motivated
  • Scheduling, planning, and follow-up skills
  • Ability to interface effectively with a diverse population
  • Ability to work independently and with teams
  • Broad knowledge about the community, specific health issues, and health and social service systems
About the Hiring Group:

As part of the Enlightened Clinical Support team, you will be responsible for engaging the member and providers to assess, plan, and establish individual member goals.

Benefits:
  • Medical/Dental/Vision Insurance with Health Savings Accounts (HSA)
  • Flexible Spending Account(s) (FSA)
  • 401(k) Retirement Plan
  • Paid Holidays, Vacation, and Sick Leave
  • Professional Training and Development Reimbursement

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