Corp Prov Network Account Exec

Role Overview: The Corporate Provider Network Management Account Executive plays a critical role in developing high-performing provider networks that meet state and Centers for Medicare & Medicaid Services (CMS) requirements for new and expanding markets. In this dynamic and fast-paced role, you will identify and recruit key providers, negotiate contracts, and establish trusted partnerships with healthcare professionals and organizations at a rapid pace. You will also contribute to the strategic direction of network development by creating business plans, process flows, and customized solutions that support organizational objectives.

Work Arrangement:

• Remote - Associate can work remotely anywhere in the United States.
• This position requires 50-60% travel.

Responsibilities:

• Identify, contact, and recruit qualified providers to participate in the Plan network across new and existing service areas.
• Negotiate contracts with hospitals, physicians, and ancillary providers.
• Engage with providers at all organizational levels and across diverse system types.
• Maintain consistent communication and follow-up with prospective providers until the enrollment process is complete.
• Submit complete and accurate provider applications to the credentialing department to support timely processing.
• Document and report issues that may impact recruiting efforts.
• Stay current on all Request for Proposal (RFP) and application requirements relevant to network development.
• Maintain clear, accurate records of all provider interactions and activities.
• Support team members by identifying challenges and contributing innovative solutions that enhance processes and expand the use of technology.
• Foster collaborative working relationships and build trust across teams.
• Recommend creative operational approaches to reduce backlogs and improve resource utilization.

Education & Experience:

• Bachelor’s degree in Business, Healthcare Administration, Healthcare Management, or a related field is required
• 2 to 3 years of experience in Medicaid, Medicare, Exchange or Commercial Provider Contracting preferred.
• 5 to 7 years of progressive business experience in provider network management.
• Strong knowledge of provider network management processes and programs, including Performance Improvement Plans (PIPs), hospital savings initiatives, Accountable Care Organizations (ACOs), and Patient-Centered Medical Homes (PCMH), is strongly preferred.

Licensure:

• Valid driver’s license and car insurance required.

Skills & Abilities:

• Strong understanding of customer and market dynamics and key business drivers.
• Commitment to working collaboratively and strengthening provider networks.
• Strong negotiation, communication, and active listening skills.
• Demonstrated leadership and proven ability to achieve results.