AllentownRecruiter Since 2001
the smart solution for Allentown jobs

Provider Network Account Executive I

Company: AmeriHealth Caritas
Location: Allentown
Posted on: March 24, 2020

Job Description:



Provider Network Account Executive I



Location



Allentown, PA



Telecommuter?



Yes



ID**

18630








Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.


Responsibilities:

The AE I is responsible for building, nurturing and maintaining positive working relationships between Plan and its contracted providers. Assigned provider accounts may include single or multiple practices in single or multiple locations, integrated delivery systems or other provider organizations. AE I maintains in depth understanding of Plan's contracts and provider performance and needs, identifying, developing and conducting relevant and tailored provider orientation sessions, making educational visits and working to resolve provider issues. Responsible for monitoring and managing provider network by assuring appropriate access to services throughout the Plan's territory in keeping w/ State and Federal contact mandates for all products. Identifies, contacts and actively solicits qualified providers to participate in Plan at new and existing service areas and products, assuring financial integrity of the Plan is maintained and contract management requirements are adhered to, including language, terms and reimbursement requirements. Maintains complete understanding of Plan reports and metrics and uses them to evaluate the performance of assigned providers/practices/facilities, determining, communicating and implementing plans for providers to improve performance and measuring ongoing performance. Uses data to develop and implement methods to improve relationship. Assists in corrective actions required up to and including termination, following Plan policies and procedures. Supports the Quality Management department with the credentialing and re-credentialing processes, investigation of member complains and any potential quality issues. Maintains a functional working knowledge of Facets, including the provider database and routinely relays information about additions, deletions or corrections to the Provider Maintenance Department. Maintains and delivers accurate, timely activity and metric reports as required. Identifies and maintains strong partnerships with appropriate internal resources and stakeholders.

Education/Experience:


  • 1-3 years experience in a Provider Services position working with providers.

  • 3-5 years experience in the managed care/health insurance industry.

  • Medicaid experience preferred.

  • Demonstrated strength in working independently, establishing influential relationships internally and externally, meeting and training facilitation skills, priority setting and problem solving skills.

  • Valid Drivers License



Keywords: AmeriHealth Caritas, Allentown , Provider Network Account Executive I, Other , Allentown, Pennsylvania

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Caregiver - Great Pay + Benefits!
Description: Are you looking for a different type of Caregiver position One that actually delivers on the perks promised Well, you just found it. Come work with an In
Company: CareInHomes
Location: Levittown
Posted on: 04/9/2020

Crisis Rates Telemetry - Tele Travel Nurse RN
Description: Nationwide Travel Nurse Assignments - Telemetry RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified (more...)
Company: Travel Nurse Jobs
Location: Levittown
Posted on: 04/9/2020

Crisis Rates - MICU Travel RN - Medical Intensive Care
Description: Nationwide Travel Nurse Jobs - Medical Intensive Care RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified (more...)
Company: Travel Nurse Jobs
Location: Levittown
Posted on: 04/9/2020


Travel Nurse Tele RN (Telemetry)
Description: Nationwide Travel Nurse Assignments - Telemetry RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified (more...)
Company: HCEN
Location: Levittown
Posted on: 04/9/2020

Travel Nurse RN Open Heart Intensive Care (CVICU)
Description: Nationwide Travel Nurse Jobs - Cardiac Intensive Care Unit RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for (more...)
Company: Travel Nurse Jobs
Location: Levittown
Posted on: 04/9/2020

Short Shifts, Great Pay - In Home Caregiver
Description: No Certification No Problem We are hiring caregivers of all skill levels to provide compassionate In Home Care to
Company: CareInHomes
Location: Levittown
Posted on: 04/9/2020

In-Home Caregiver
Description: We are hiring caregivers for all kinds of in home positions near you We make sure that all caregivers on our care team are given every available resource so that you
Company: CareInHomes
Location: Levittown
Posted on: 04/9/2020

Warehouse Associate
Description: Job Description br Position Purpose: br Warehouse associates are an essential part
Company: The Home Depot
Location: Levittown
Posted on: 04/9/2020

Team Member - Food Champion
Description: Presents a neat, clean appearance, in company uniform Greets each customer they encounter with a smile and a word
Company: Taco Bell
Location: Levittown
Posted on: 04/9/2020

Crisis Rates PCU Travel Nurse - Progressive Care Unit
Description: Nationwide Travel Nurse Jobs - Progressive Care Unit RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified (more...)
Company: Travel Nurse Jobs
Location: Levittown
Posted on: 04/9/2020

Log In or Create An Account

Get the latest Pennsylvania jobs by following @recnetPA on Twitter!

Allentown RSS job feeds