FQHC Provider Network Account Manager

Job Description

Serve as plan liaison for physicians/physician groups in a specified geographical area. Will be the main point of contact for all plan related issues including marketing enrollment contracting billing and reimbursement.

Responsible for the resolution of all issues including those identified by the provider and those identified internally that have an impact on the physician. Coordinates with all Healthfirst staff to assist as appropriate including creating project plans issue logs conference calls etc.

Responsible for the provider recruitment process. Identify gaps complete paperwork etc.

Schedule frequent and regular face-to-face contact with the practice locations to identify any issues and ensure plan visibility.

Keep abreast of competitor activity including new reimbursement and marketing strategies. Negotiate favorable/competitive rates with providers based on market trends.

Conduct new provider orientation and identify opportunities for education on both clinical and administrative topics. Includes experts in the field of education as needed from in-house staff.

Responsible for monitoring and reporting on providers clinical quality & financial performance working with their manager and other internal departments to create strategic improvement plans.

Working under light supervision maneuvers multiple tasks independently with a fast paced proactive vs. reactive approach to changing priorities while meeting departmental objectives. Attention to managing many details and remaining focused in an environment with distractions.

Contribute creative solutions and ownership of daily assignments for seamless communication and systematic completion of routine and special projects. Follow protocols and use common sense to escalate situations to management appropriately.

Handle other duties as assigned with the occasional need to work weekends overtime and/or travel throughout the tristate area. Engage in mastering the Divisions impact on Healthfirst its Members and Providers

Minimum Qualifications:

High School Diploma or GED equivalent experience

Medicare and/or Medicaid managed care experience

Excellent oral and written communication skills (Letter writing Memo and Email)

Preferred Qualifications:

Bachelors Degree from an accredited institution

Active driver license and access to a vehicle

Provider office operations experience

Ability to understand Provider claims reimbursement

Contract negotiation experience

Bilingual fluency (reading writing speaking) Chinese or Spanish and English

Exposure to multiple functions especially finance business intelligence

Experience with Microsoft office such as Excel Outlook and/or electronic archiving

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race color creed religion sex national origin sexual orientation pregnancy age disability genetic information domestic violence victim status gender and/or gender identity or expression military status veteran status citizenship or immigration status height and weight familial status marital status or unemployment status as well as any other legally protected basis. HF Management Services LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment please contact us by sending an email to or your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services LLC.

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Hiring Range*:

• Greater New York City Area (NY NJ CT residents): $67200 - $97155

• All Other Locations (within approved locations): $59800 - $88910

As a candidate for this position your salary and related elements of compensation will be contingent upon your work experience education licenses and certifications and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary Healthfirst offers employees a full range of benefits such as medical dental and vision coverage incentive and recognition programs life insurance and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in good faith would pay to a new hire or for a job promotion or transfer into this role.