Healthcare Operations Manager
4 days ago
About the Role:
The Account Manager is responsible for managing and coordinating the integration of Health Plans, Government Programs, Employers, MA and Individual contracting with the Population Health Services Organization (PHSO) and AdventHealth provider network.
Key Responsibilities:
• Develop and manage effective primary relationships with key stakeholders, supports professional negotiation, responsive communication, problem resolution to meet customer expectations.
Account Management:
• Operational Management of accounts, products or programs: facilitate work teams, track deliverables, problem solve, issue resolution
Contract Management:
• Reviews contract provisions and administrative issues with leadership and pursues opportunities to improve profitability and retention.
Negotiation and Communication:
• In preparation for renegotiations, gather underwriting data, review claims experience, review the recommended renewal action and prepares a summary justifying the renewal and recommending changes when appropriate.
Proposal and Presentation:
• Reviews proposal requests, providing all appropriate information to leadership, and present or assist in the presentation of the proposal to the Health Plans or Employers.
Education and Experience:
The Account Manager requires a Bachelor's degree in a related field and a minimum of three years of experience in the field of health insurance.
AdventHealth:
AdventHealth is a clinically integrated, physician-led network, including North Kansas City Hospital, Advent Health and The University of Kansas Health System, and independent primary care and specialist physicians.
Community Involvement:
Centrus Health is a high-quality value-based network for government and commercial payers and employers since 2018, committed to improving the health and well-being of the community.
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