AmeriHealth Caritas Provider Network Account Executive I in Baton Rouge, Louisiana

Provider Network Account Executive I

Location: Baton Rouge, LA

Telecommuter?: Yes

ID**: 14160

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com .

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

  • Manages day-to-day client contacts and requests of assigned accounts and elevates issues to the next level as appropriate.

  • Manages client relationships to ensure client’s needs are met.

  • Prioritizes client requests as appropriate.

  • Oversees and ensures timely resolution of client issues, including eligibility, network concerns, ID card issues and other related claims processing issues.

  • Ensures timely delivery of client monthly/quarterly reports.

  • Interfaces and manages operational issues with LaCare functional areas.

  • Develops LaCare performance improvement plans when necessary, and monitors performance guarantees.Manages contract compliance with each client and reports non-compliance to manager.

  • Investigates and attempts to resolve all customer complaints and elevates unresolved issues as necessary.

  • Drafts and updates LaCare client policies on a routine basis as necessary.

  • Participates in the planning and execution of quarterly client visits.

  • Proactively develops an understanding of existing client’s key issues and business requirements and works with internal team to meet business requirements.

  • Maintains current knowledge base of program services, policies and procedures regularly reviewing and reacting to policy updates and departmental procedures.

  • Performs other related duties and projects as assigned.

  • Attends required training on an annual basis.

  • Supports and carries out the Mercy Mission & Values.

  • Adheres to AMFC policies and procedures.

  • Creates and supports an environment which fosters teamwork, cooperation, respect and diversity.

  • Establishes and maintains positive communication and professional demeanor with AMFC employees and clients at all times.

  • Demonstrates and supports commitment to corporate goals and objectives.

  • Adheres to AMFC policies and procedures. Supports and carries out the Mercy Mission & Values.

Education/Experience:

  • Bachelor’s Degree or equivalent work experience.

  • 1-2 years' Medicaid experience preferred; 1 year in a Provider Services position.

  • 3 years' in the managed care/health insurance industry.

  • Previous experience working with healthcare providers.

EOE Minorities/Females/Protected Veterans/Disabled