Account Manager of Population Health Network Operations
at Adventist Health System

Date Posted: 3/14/2017

Job Description



Job:  Other Non-Clinical Professional

Organization:  Adventist Health System Corporate Office

Shift:  Adventist Health System - Courtland

Job Posting:  Full-time

If you want to be a part of a place that provides nothing less than extraordinary compassionate care, then Adventist Health System is the place for you!

We are currently seeking qualified candidates for an Account Manager position that will be based in our PHSO Network Operations department. This position is based at our Courtland Campus in Orlando, FL.

The Account Manager manages and coordinates the integration of Health Plans, Government Programs, Employers, MA and Individual contracting with the Population Health Services Organization (PHSO) and AHS provider network.   The account manager is responsible for supporting the business growth, and retention by developing and maintaining effective account management strategies that achieve contract outcome success.  The populations will typically range between 25 – 75K+ lives with complicated plan designs, sensitive administrative duties in multiple regions. In addition, the Account Manager participates, and leads elements of, strategic and general business planning for the growth and development of the PHSO.  Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. 

Specific job duties include:
 
  • Develop and manage effective primary relationships with key stakeholders, supports professional negotiation, responsive communication, problem resolution to meet customer expectations. 
  • Work with clients to understand their concerns and needs and act as liaison between the PHSO departments and the customers to initiate plan improvements, escalate and resolve administrative inconsistencies timely and implements corrective action plan when needed.
  • 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.  
  • Reviews contract provisions and administrative issues with leadership and pursues opportunities to improve profitability and retention. 
  • 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. Follow expectations for tracking activity in designated software program.  
  • Supports and is actively involved with the provider reps and negotiation teams in the acquisition, submission and implementation of accounts. Supports joint product development process for Government, Commercial, MA and Individual products.
  • Lead and coordinate the submission, set up and implementation of assigned new populations with the PHSO teams.
  • Partners with the Health plans to facilitate the enrollment process, which may involve preparation of enrollment materials, conducting enrollment meetings or being present at benefit fairs.
  • Serve as mentor and Liaison with all service lines offer by the PHSO. 
  • Support company initiatives by implementing changes and/or participating in project work.
  • Educates the PHSO teams on the strategies and operations of new business.
  • Responsible for the financial performance and implementation of corrective action plans.
  • Works jointly with PHSO teams to track deliverables and manage metrics.
  • Manages or facilitates the cross-functional and cross-organizational work teams needed to grow and support the PHSO and AHS Division Initiatives.

Job Requirements

Education Requirements:
 
  • Bachelor’s degree in a related field, such as Business, Marketing, or Communications.
  • Master’s degree in a related field, such as Business Administration, Healthcare Administration, or Public Administration.
 
Experience Requirements:
 
  • A minimum of five years of experience in the field of health insurance (with an HMO, health insurer, TPA or broker) sufficient to yield the knowledge requirements above.

If this position sounds like a great match for your skills set and experience, please apply online now!


Job Snapshot

  • Employee Type:
  • Location: Orlando, FL
  • Job Type: Management
  • Experience: Not Specified
  • Date Posted: 3/14/2017

About Us

About Adventist Health System

Who We Are

We are one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.

Who You Are

You are a compassionate, talented professional who wants to work in an environment where you can live out your faith and your values. You are excited about being part of a team that uses the latest technology and medical research to ensure patients receive quality care, but who also recognize that great care is always personal. You enjoy going out of your way to make each patient and their family feel special, and are passionate about guiding them toward optimal health.

Our Community

Our community is global and so is our reach. From coordinating medical mission trips in Ethiopia to planting school gardens in Florida, we are constantly seeking ways to go beyond hospital walls in improving the health of our communities. As a member of our team, you will be encouraged to use your talents in fun, meaningful ways that bring joy and healing to people around the world.

Our Mission

Part of this worldwide network, Adventist Health System was founded in 1973 to support and strengthen the Seventh-day Adventist health care organizations in the Southern and Southwestern regions of the United States. Today it is a national leader in quality, safety and patient satisfaction, comprised of 46 hospital campuses and nearly 77,000 employees.

Although separated by geography, each of our facilities is united by the mission of Extending the Healing Ministry of Christ. Today we continue the tradition of whole-person care by practicing and sharing CREATION Health, a blueprint for living a healthy, happy life based on the principles given in the Bible’s creation story: Choice, Rest, Environment, Activity, Trust, Interpersonal relationships, Outlook and Nutrition.

We provide comprehensive benefits, training and advancement opportunities. We care for our employees as well as we care for our patients.