Manager Health Plans Large Accounts
US-CA-Rancho Cordova
commonspirit_careers
Req #: 374485
Type: Day
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Overview: CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community. Responsibilities: *This is a remote position.* Do you want to be on the leading edge of integrating health insurance and medical provider networks? We are creating health plan solutions leveraging our clinically integrated networks and care coordination services and would love to have you join our team! Job Summary This is a key position on the Employer Strategy & Relationships Team responsible for leading the development and execution of a market strategy to grow accretive contribution margin by developing, selling and implementing employer programs based on narrower network/program designs to help employers better control their health plan costs and plan assets and improve the value of health care. Programs are delivered in partnership with selected, strategic partners (TPAs and/or selected Payers) and focus on optimizing the use of CommonSpirit Health facilities and affiliated providers. Programs also require enhanced partnerships with physicians and physician networks, with a particular focus on leveraging the capabilities of clinical integration networks, as well as internal and external partners. Essential Key Job Responsibilities * Leads account management and maintains overall accountability for client satisfaction, retention, and growth. May direct one or more account managers. * Builds strong relationships and trust with clients, anticipates client and member needs for communications and services and makes recommendations. * Leads client and member communications planning and execution. * Accountable for resolution of escalated member issues. Ensures that the client and member perspective is a driving force behind our actions and business decisions. * Coordinates implementation meetings and work very closely with Sales, Brokers/Consultants and TPA in the creation of client specific implementation plans, to ensure that all clients' needs and expectations are met or exceeded, "client delight". Proactively leads strategic account planning meetings by coordinating and partnering with the TPA, Analytics, and Network Management to produce monthly and quarterly client reports regarding utilization, case and disease management, etc. Works with all parties to ensure that reports are produced for all measurable goals and objectives. * Works with leadership, local market executives and cross-functional teams (with internal and external entities) to ensure that clients' needs and expectations are met and to improve account management processes and tools to better serve our clients. * Leads solution development efforts that best address customer needs, while coordinating the involvement of all necessary team members. Crafts and implements service practices that meet clients', members' and own organization's needs. Qualifications: Education and Experience: * Bachelor's degree * Minimum of seven (7) years client management, account management, client or sales relationship development * Healthcare insurance experience Licensure: * Life and Health license obtained within 6 months (through State Department of Insurance) Required Minimum Knowledge, Skills, Abilities and Training * Knowledge of account management practices, tasks, and tools and ability to provide services and support to key clients. * Working knowledge and experience with health plan performance management, reporting and presentation development. * Excellent written and verbal communications skills with demonstrated ability to build trust with clients and stakeholders. * Ability to manage collaboratively and coach others to achieve optimal performance, i.e., delegate effectively; praise/reward contributions; define clear roles and responsibilities; define function processes and tools; set goals and lead initiatives; adjust plans as necessary. * Understands how to anticipate, recognize, and deal effectively with existing or potential conflicts at the individual, group, or situation level; ability to apply this understanding appropriately to diverse situations. * Knowledge of effective self-management practices and ability to manage multiple concurrent objectives, projects, groups, or activities, making effective judgments as to prioritizing and time allocation. Preferred: * Knowledge of self-funded health plans and reinsurance. * Knowledge of health insurance products, market segments and marketplaces. * Knowledge of and ability to use the proper processes and practices for managing and administering a variety of contractual agreements.
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