Senior Network Account Manager

The Senior Account Manager is committed to the development and supervision of a high performance provider network, through various provider engagement strategies which follow four core principles: Quality, Clinical Efficiency, Administrative Efficiency, and Population Health. The individual at this level functions as a cultural ambassador and strategy driver for Healthfirst. He/she will embody Healthfirst’s Standards of Excellence through his/her workplace behavior. S/he will also promote and reinforce subordinate behavior that is consistent with Healthfirst’s desired culture and fulfill his/her role in aligning Healthfirst’s strategic initiatives with the desired organizational culture. Advance Healthfirst through superior customer service focused leadership in an assigned territory and team, optimizing provider satisfaction. Educate and train network representatives in key business principles around profitability, network adequacy, and quality. Promote successful internal collaboration within Healthfirst by sharing mutual goals with hospital and affiliated provider teams, providing education and communication about Healthfirst benefits and policies, developing and delivering reports for provider partners, and proposing initiatives or process changes that encourage improvement. Provide customer service focused leadership to resolve provider issues promptly and accurately. Ensure project status reporting and timely completion of assigned projects. Provide coaching and mentoring for staff. Identify areas for improvement and recommend training or education. Apply critical thinking to solve problems and analyze impacts on provider operations. Demonstrate understanding of reimbursement methodologies related to community provider network. Ground core principles and the role of hospitals within Clinical Efficiency, Population Health, and Administrative Efficiency. Identify trends and root causes, develop action plans to close gaps. Review and draw conclusions from reports, integrating knowledge and practical application. Understand reimbursement and utilization practices, including fiscal aspects. Analyze reports on provider performance and relate practice patterns to overall trends. Negotiate discussions with escalation lines and present approvals to senior management. Understand regulatory and legal contracting logistics and contract terms (financial, amendment, termination). Translate contract terms into system rules—configure, create, or amend new provider records and ensure accuracy of future claims. Guide and facilitate the team’s contracting process from start to finish. Minimum Qualifications Medicare and/or Medicaid managed care experience. Provider office operations experience. Understanding of provider claims reimbursement. Professional writing skills (letter, memo, email). Hiring Range Greater New York City Area (NY, NJ, CT residents): $122,900 - $188,020 All Other Locations (within approved locations): $105,100 - $160,480 As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, for a job promotion, or a transfer into this role. Benefits Healthfirst offers employees a full range of benefits such as medical, dental, and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. If you have a disability under the Americans with Disabilities Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to View email address on click.appcast.io or calling View phone number on click.appcast.io. In your email include a description of the accommodation you are requesting and the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the supplied e‑mail address and phone number. Thank you for considering a career with HF Management Services, LLC. Know Your Rights. WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified. #J-18808-Ljbffr Healthfirst, Inc.