Healthcare Account Manager

1 week ago

Canton, Massachusetts, United States Point32Health, Inc. Full time

About Point32Health

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. Our mission is to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

Job Summary

This leader is responsible for cultivating, maintaining and strengthening relationships with our network of behavioral health providers and trade associations, in all geographic areas where we do business. Additionally, this person helps shape strategy and policies relevant to our behavioral health provider network. While working across the business, this individual will create positive working relationships with providers, resolving provider inquiries and navigating the nuances of our markets, including regulatory requirements. This position requires a proactive self-starter with independent initiative and strong skills to strategically lead the behavioral health provider account management team.

The Provider Account Management Manager will manage a staff who are liaisons internally between departments within Point32Health and externally with providers. Working in a heavily matrixed environment, the Manager of Provider Account Management (or Manager of Provider Relations) must possess flexibility, management skills, leadership skills, ability to think and act strategically, independent initiative and excellent communications skills.

Key Responsibilities/Duties

  • Strategically manage and successfully lead the Enterprise Behavioral Health Provider Account Management Team to ensure operational issues are well managed and do not get escalated and/or interfere with negotiations with our Contracting team.
  • Manage and coordinate the resources, responsibilities, processes, and workflows to ensure quality and timely account management support. Revise policies, processes, manuals, and documentation to maintain compliance and clinical best practices.
  • Monitor the overall progress of team initiatives and provide status updates to leadership, managers and representatives of partner departments such as Behavioral Health, Network Contracting, Medical Policy, Servicing, Product Strategy, Claims, Legal, Pharmacy, and Care Management.
  • Own and drive strategic and operational priorities for the provider, leading and bringing in support from internal corporate departments as necessary.
  • Strategically lead successful implementation of new accounts/partnerships by identifying most appropriate/suitable provider account management needs and ensuring that the provider needs are met.
  • Develop and report on KPIs, relationship metrics and measurements to ensure provider relationship as being appropriately managed. Analyze, synthesize, and interpret trends and data to identify opportunities for process improvement for both client and operations team.
  • Represent the provider voice and Point32Health voice in stakeholder meetings as well as in meetings related to medical cost management/vendor programs.
  • Collaborate cross-functionally to ensure that provider needs are met and that escalated issues are resolved.
  • Lead key provider and Point32Health internal meetings required to execute on strategies, including the development of agenda, materials, preparation and facilitation.
  • Other duties and projects as assigned.

Qualifications

  • Bachelors Degree in business or healthcare management; Masters Degree preferred.
  • Knowledge of health care insurance industry is a must (experience in behavioral health is preferred).

Experience

  • Minimum 10+ years of experience in a health care environment with a proven track record of establishing, building, and managing accounts.
  • Management experience as well as program management experience, including leading cross functional initiatives and project management is necessary.
  • Experience in behavioral health preferred.

Skills

  • Experience in the health insurance field specifically with contracting, provider reimbursement, and claims concepts is needed. Experience with Commercial, Medicaid, and Medicare reimbursement methodologies is preferred.
  • Excellent communication and interpersonal skills, including presentation, verbal and written skills.
  • Ability to be a team leader and a team player, managing group dynamics to effectively reach a positive outcome.
  • Ability to understand strategic objectives and develop operational processes to support these objectives.
  • Ability to connect the big picture with the operational details.

Working Conditions and Additional Requirements

  • Must be able to work under normal office conditions and work from home as required.
  • Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
  • May be required to work additional hours beyond standard work schedule.

Point32Health is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive and accessible workplace culture.

Compensation and Total Rewards

As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Companys sole discretion and may be modified at the Companys sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

  • Medical, dental and vision coverage
  • Retirement plans
  • Paid time off
  • Employer-paid life and disability insurance with additional buy-up coverage options
  • Tuition program
  • Well-being benefits
  • Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit

Commitment to Diversity, Equity, Inclusion, Accessibility and Health Equity

Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do-from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity teams strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Scam Alert

Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact

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