[Remote] Sr Account Executive

Note: The job is a remote job and is open to candidates in USA. AmeriHealth Caritas is a mission-driven organization with over 30 years of experience in healthcare solutions. They are seeking a Senior Account Executive to develop strong relationships with providers, driving performance related to risk-based and cost-sharing arrangements as well as managing large health system contracts.ResponsibilitiesSupports network development and network management strategiesResponsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communicationResponsible for participating and implementing Provider Network education programs and materials (both internal and provider targeted) and is assigned to train, mentor and support new AE’sResponsible for hospital and physician network development and management; including joint operating committees (JOC) for identified groups, oversight of necessary quality review meetings with targeted providers and/or health systemsResponsible for building, nurturing and maintaining positive working relationships between Plan and its contracted providers; including those that are most complexResolve Provider disputes in a timely and compliant mannerResponsibility for a higher number of multiple practice locations and multi-specialty practices and multiple providers. Should also include hospital systems, contracted subcontractors (DME, Vision, etc.), and ancillary providersDevelop/implement/manage programs and projects that support/impact high dollar and high member provider groupsPerform site visits as neededOversee resolution of provider issues managed by other Provider Network support teamsTake corrective actions required up to and including termination, following Plan policies and proceduresOperationalizes completed contracts with advanced complexityConsults on VBC contracts, facilitates for success (JOCs, performance overview, etc.) with specific bonuses attached to performance improvementResponsible to maintain and manage Value-Based contract requirements, including but not limited to; monitoring performance standards against VBC or State program requirements, working with key stakeholders and provide oversight on applicable data-sharing or report requirementsResponsible for hospital and physician network development and management; including joint operating committees (JOC) for identified groups, oversight of necessary quality review meetings with targeted providers and/or health systemsGeneral Operational Knowledge related to provider satisfaction, education, and communication with a fundamental understanding of operational items such as claims, payment integrity, provider data, credentialing, appeals disputes etcSupport contracting for multiple product lines, including LTSS, Exchange, DSNP adequacy gaps (high complexity)Assist with recruiting providers based on identified network adequacy gaps (high complexity)Support of VBC negotiations; lead in VBC relationships; may lead negotiationsSkillsAssociate's Degree requiredSeven years' experience if no bachelor's degreeFive (5) or more years strong communication skillsFinancial acumenAbility to have difficult conversationsBachelor's Degree preferredBenefitsFlexible work solutions including remote optionsHybrid work schedulesCompetitive payPaid time off including holidays and volunteer eventsHealth insurance coverage for you and your dependents on Day 1401(k)Tuition reimbursementCompany OverviewAmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill. It was founded in 1982, and is headquartered in Philadelphia, Pennsylvania, USA, with a workforce of 10001+ employees. Its website is http://www.amerihealthcaritas.com.