The Plan Account Manager is a key executive position for the Medicare Advantage Plan and for AllyAlign Health (AAH), acting as a liaison between AAH Plan Partners and the AAH operations team, providing leadership on behalf of the Executive Director, and supporting all Plan operations. The Account Manager reports to an Executive Director and has responsibility for one or more Plans.
Work closely with assigned AAH Executive Director to Implement new AAH health plan or significant health plan expansion within defined parameters (Cost/Staffing/Schedule) to meet CMS requirements.
Transitions new / expanding AAH health plan from implementation into full operations mode.
Manages day-to-day activities and issues throughout the implementation and operations phases, escalating issues as warranted to the assigned Executive director.
Executes on strategies and goals set by the Plan Board of Directors, Plan Executive Director, and the AAH Senior Management Team for improving operational execution and delivering value to customers and members.
Identifies operating business risks/opportunities and identifies strategies to eliminate/mitigate/capitalize as appropriate.
Prepares Board meeting materials and packets, prepares and distributes regular Plan reports, and maintains regular weekly or bi-weekly meetings with Plan Partners.
Hire, train and manage Plan’s Member Advocate team to provide prompt, friendly onsite provider relations and customer service.
Coordinates with the Sales team to establish member growth programs and manage campaigns to achieve top line revenue targets.
With the Executive Director, manages network strategy, adequacy, and access and service.
Engages in supporting all Plan activities including Network Relationships, Value Based Contracting Initiatives, Plan Enrollment, Operations, member and provider support
Meets regularly with key Plan physicians, physician staff, and SNF/NF facilities to gauge satisfaction with the Plan, communicate key Plan initiatives, and maintain a sense of Plan community.
Actively supports securing contracts with Providers for “preferred” and “required” network adequacy as needed.
Identifies new business opportunities in Plan markets.
Monitors and reports on key financial metrics for the Plan; is knowledgeable about Plan financial reporting.
Contributes to the Plan’s operating budget.
Works directly with AAH’s operating team to solve customer service and provider relations issues.
Bachelor’s degree required
Strong communication and presentation skills
Travel as required within defined plan geography and occasional out-of-state, overnight travel.
Minimum 2 years of Medicare Advantage managed care experience, preferably with a focus on contracting or provider relations; or ability to demonstrate valuable, related experience
Familiarity with skilled nursing facility operations and financing
Technical and financial understanding of health care operations
Strong analytical and problem-solving skills
Excellent computer skills including Word and Excel
Additional Salary Information: Plus Generous Bonus Program
Internal Number: 1
An Experienced Managed Services Partner
AllyAlign ignites significant reform in the $357 Billion U.S. long-term care healthcare eco-system by enabling innovative risk and payment models among payers, providers and consumers.