Senior Account Manager, Provider Engagement

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

Position Overview

Reporting to the Director of Provider Engagement, the Sr, Account Manager is responsible for the developing key provider relationships and driving high performance of key providers. Serving as the one-stop “Quarterback” for high profile groups, including coordinating Quarterly Business Reviews (QBR) and various operational meetings to drive performance and a world-class engagement experience. Success in this role will be measured by aligned goals that include but are not limited to membership growth, quality, risk adjustment, utilization management, and overall financial performance.

• Develop and establish key provider partnerships aligned with MetroPlusHealth business goals.
• Review data and analytics of key provider group performance to determine areas of focus and develop improvement opportunities.
• Develop strategies and action plans that align key provider groups with company goals.
• Collaborate effectively with internal functions such as Quality Management, Risk Adjustment, Clinical Services, Sales and others to monitor trends and develop strategic plans to improve performance.
• Demonstrate understanding of providers’ business goals and strategies to facilitate the analysis and align on partnership goals.
• Establish effective Quarterly Business Reviews (QBR) with a formal agenda that includes but is not limited to financial, quality, utilization, and membership reporting.
• Develop and maintain executive level monthly reporting on all Provider Engagement activity, performance, and progress to goals.

• Master of Public Administration (MPA) or Master of Public Health (MPH) degree required; and
• Minimum 3 years of relevant Healthcare industry experience in a provider network management and value-based environment; or
• A satisfactory equivalent combination of education, training, and minimum 5 years of relevant Healthcare industry experience in a provider network management and value-based environment.
• Solid background in healthcare, preferably experience working in a network management and value-based role.
• Must have excellent healthcare and financial data analysis skills.

Professional Competencies

• Integrity and Trust
• Customer Focus
• Functional/Technical skills
• Written/Oral Communication
• Ability to decipher contractual language and clearly deliver messages to clients and customers with written and verbal communication.
• Excellent verbal and written communications skills with demonstrated ability to communicate, present, and influence both credibly and effectively at all levels of an organization, including executive and C-level.
• Demonstrated self-starter, strategic thinker, and ability to manage complexity and ambiguity.
• Adaptable quickly to change in an ever-changing environment.
• Ability to develop solid long-term positive working relationships.
• Ability to drive effective provider performance
• Strong business acumen, analytical, critical thinking, and persuasion skills

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