Senior Account Manager, Provider Engagement

3 weeks ago

New York, New York, United States NYC Health Hospitals Full time

MetroPlusHealth is a leading provider of healthcare services in New York City, serving residents of the five boroughs through a comprehensive range of products, including Medicaid Managed Care, Medicare, and Child Health Plus.

As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth has a network of over 27,000 primary care providers, specialists, and participating clinics.

The Senior Account Manager, Provider Engagement will play a critical role in developing key provider relationships and driving high performance of key providers.

Responsibilities will include coordinating Quarterly Business Reviews (QBR) and operational meetings to drive performance and a world-class engagement experience.

Success in this role will be measured by aligned goals that include but are not limited to membership growth, quality, risk adjustment, utilization management, and overall financial performance.

Key Responsibilities
  • Develop and establish key provider partnerships aligned with MetroPlusHealth business goals.
  • Review data and analytics of key provider group performance to determine areas of focus and develop improvement opportunities.
  • Develop strategies and action plans that align key provider groups with company goals.
  • Collaborate effectively with internal functions such as Quality Management, Risk Adjustment, Clinical Services, Sales and others to monitor trends and develop strategic plans to improve performance.
  • Demonstrate understanding of providers' business goals and strategies to facilitate the analysis and align on partnership goals.
  • Establish effective Quarterly Business Reviews (QBR) with a formal agenda that includes but is not limited to financial, quality, utilization, and membership reporting.
  • Develop and maintain executive level monthly reporting on all Provider Engagement activity, performance, and progress to goals.
Requirements
  • Master of Public Administration (MPA) or Master of Public Health (MPH) degree required.
  • Minimum 3 years of relevant Healthcare industry experience in a provider network management and value-based environment.
  • Solid background in healthcare, preferably experience working in a network management and value-based role.
  • Excellent healthcare and financial data analysis skills.
  • Professional Competencies: Integrity and Trust, Customer Focus, Functional/Technical skills, Written/Oral Communication, Ability to decipher contractual language and clearly deliver messages to clients and customers with written and verbal communication.

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