Licensed Account Manager

3 weeks ago

Jacksonville, Florida, United States Longevity Health Plan Full time
Job Description

Job Title: Licensed Account Manager

Job Summary: We are seeking a highly motivated and experienced Licensed Account Manager to join our team at Longevity Health Plan. The successful candidate will be responsible for managing relationships with skilled nursing facilities, identifying business opportunities, and developing strategies to achieve sales goals.

Key Responsibilities:

  • Coordinate all plan functions related to assigned facilities and lead joint team efforts to deliver high-quality and cost-effective programs of care.
  • Serve as the main point of contact between facilities and the plan, collaborating with facility management and staff to ensure quality services are provided to members and plan administrative functions are carried out effectively.
  • Maintain regular visit schedules for assigned SNFs, visiting each at least monthly and ensuring ongoing communication with all relevant SNF leaders and LHP champions.
  • Manage SNF contractual relationships and ensure accurate administration of contract terms, leading and participating in multidisciplinary teams comprised of contracted provider representatives.
  • Identify and resolve operational issues between the plan and facility, coordinating implementation of solutions to ensure positive long-term working relationships.
  • Provide ongoing intervention and assistance in the management of contracting, claim payment, facility and provider credentialing, requests for records or data review related to HEDIS or other reporting needs or audits as required, coordinating all communication between Longevity and the facility.
  • Complete monthly data reviews and present educational/best practice topics at cross-functional meetings with SNF leadership teams.
  • Establish facility-specific strategies and enrollment goals with the Market VP and enact strategies within assigned facilities.
  • Identify key providers and support contracting efforts by developing relationships with IPAs, hospitals, and key specialty services.
  • Lead the implementation of I-SNP participating providers in their region and ensure that all assigned participating nursing facilities and related providers are prepared to offer Longevity ISNP programs.
  • Verify each facility is prepared to successfully launch I-SNP according to schedule and oversee all aspects of a compliant ISNP program at the facility by coordinating all activities across Longevity for the facility, with Longevity vendors and back-office operations, and acting as the liaison with relevant and local provider networks.
  • Ensure correct and complete member records within various LHP-utilized systems with the support of clinical teams.
  • Regularly document market-based efforts and current partner interactions, barriers, action plans, etc. to drive increased engagement and high levels of I-SNP penetration.
  • Assist in the development of materials and present as needed during Monthly Operating Review meetings, Business Development meetings, and partner-facing Joint Operating Committee meetings.
  • Participate in weekly market/clinical team calls and monthly clinical-focused meetings.
  • Ensure contract compliance with all requirements as set forth by State and Federal agencies.
  • Define and develop sales opportunities within assigned territories.
  • Educate Skilled Nursing Facility personnel on Longevity Health Plan benefits and compliant lead generation.
  • Generate leads through education, relationships, and ongoing SNF census reviews.
  • Conduct benefit presentations with potential members, family members, or Responsible Parties.
  • Complete daily lead management and required documentation.
  • Ensure timely and accurate application processing.
  • Participate in Sales-focused meetings and coordinate with Regional Sales Managers for ongoing job training and support.
  • Ensure, enforce, and support the organization's strict adherence to the Company's Compliance Plan and Standards of Conduct with emphasis on compliance with established procedures and protocol, internal controls, and maintaining the highest level of workplace behavior.
  • Support the compliance program in identifying and responding to compliance deficiencies and corrective action plans.
  • Comply with Sales Agent ethics standards in accordance with applicable statutes and regulations.
  • Enforce policies and programs that encourage employees and related entities to report suspected fraud and other improprieties without fear of retaliation.
  • Supervise and execute special projects as assigned.
  • Perform other related duties as assigned.

Requirements:

  • License to sell Medicare-Health Insurance Producer License, or ability to obtain one within 60 days of hire.
  • Valid state driver's license with a good driving record and proof of automobile insurance required.
  • Auto liability insurance declaration page with minimum limits of $100,000/$300,000 for bodily injury and $100,000 for property damage with combined single limit of $300,000.

Education and Training:

  • Bachelor's degree required.

Knowledge and Experience:

  • Relevant Work Experience: 3 plus years of healthcare industry experience with focus on provider relations, contracting, and business development.
  • Minimum 2 years of sales experience.
  • Excellent communication and presentation skills to all levels of staff and management.
  • Strong written and verbal communication skills.
  • Strong project management and coordination skills.
  • Ability to understand complex and comprehensive contractual arrangements which requires a depth of understanding of managed care, negotiations, and various high-volume services.
  • Travel in assigned territory/possible travel to other markets as needed/interested.
  • Proficiency in computer skills and Microsoft Office Suite products.
  • Comfortable working in a Skilled Nursing Home environment.

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