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Account Manager PHSO Network Operations -AdventHealth

All the benefits and perks you need for you and your family:

· Benefits from Day One

· Paid Days Off from Day One

· Student Loan Repayment Program

· Career Development

Centrus Health

Centrus Health is a clinically integrated, physician-led network, including North Kansas City Hospital, Advent Health and The University of Kansas Health System, and independent primary care and specialist physicians. Centrus Health is a high-quality value-based network for government and commercial payers and employers since 2018. Centrus Health began with a simple question: What if we could make health care better for the people of Kansas City? Today, we’re turning what-ifs into why-nots by placing more value on patient satisfaction, improved outcomes and healthy living—all while lowering the cost of care. Our network represents a group of Kansas City’s leading providers joining together to transform our community’s health care.

Centrus Health at a Glance:

1. 4,000 providers (and counting)

2. 400 physician/provider practices

3. Locations throughout the Kansas City Metropolitan area

4. 200,000 patients in value-based arrangements

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: M-F

Shift: 8AM-5PM

Location: 2330 Shawnee Mission Pkwy, Suite 300 Westwood, KS 66205

The role you’ll contribute:

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 AdventHealth 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.

The value you’ll bring to the team:

• Operational Management of accounts, products or programs: facilitate work teams, track deliverables, problem solve, issue resolution

• 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.

Qualifications

The expertise and experiences you’ll need to succeed :

REQUIRED:

• Bachelor’s degree in a related field, such as Business, Marketing, or Communications,

• A minimum of three years of experience in the field of health insurance (with an HMO, health insurer, TPA or broker) sufficient to yield the knowledge requirements above.

EDUCATION AND EXPERIENCE PREFERRED:

• Master’s degree in a related field, such as Business Administration, Healthcare Administration, or Public Administration

LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:

• Registered health underwriter

• Current, valid State of Florida health insurance license

• Certified Associate in Project Management or PMP

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

Category: Population Health

Organization: AdventHealth PHSO Resources

Schedule: Full-time

Shift: 1 - Day

Req ID: 24034527

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.