ARC Group · 2 months ago
Provider Engagement Account Executive
New York, NY, US
Full-time
Hybrid
Senior Level
5+ years expARC Group is focused on transforming the health of communities, and they are seeking a Provider Engagement Account Executive. This role involves developing strategic partnerships with provider networks, collaborating with healthcare professionals to enhance patient care, and utilizing data analytics to improve provider performance.
ConsultingFinancial ServicesImpact Investing
Responsibilities
Develop strategic partnerships between the health plan and the contracted provider networks serving our communities
Cultivate client relations and collaborate with providers to ensure delivery of the highest level of care to our members
Participate in the development of network management strategies
Creates strategic initiatives for performance improvement
Conducts regular in-person visits with physicians to provide real-time support, discuss performance metrics, and identify opportunities for improvement in patient care and clinical practices
Focuses on value-based care model initiatives, collaborating with physicians to identify and align to performance-based agreements that incentivize better patient outcomes, cost-efficiency, and quality care
Uses data analytics to track and monitor provider performance, offering actionable feedback to help physicians optimize care delivery and meet key performance targets
Builds strong interpersonal relationships with cross functional teams both externally (provider) and internally (health plan)-C-suite Level
Expert proficiency in tools and value-based performance (VBP) in order to educate providers resulting in improved provider performance
Resolves provider issues as needed for resolution to internal partners and creating efficiencies to prevent continued concerns
Receive and effectively respond to external provider related issues
Investigate, resolve and communicate provider high dollar and high volume provider claim issues and changes
Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics
Evaluates provider performance and develops strategic plan to improve performance
Present detailed HBR analysis and create reports for Joint Operating Committee meetings (JOC)
Acts as a lead for the external representatives
Coaches and trains external representatives
Ability to travel locally 4 days a week
Performs other duties as assigned
Complies with all policies and standards
Qualification
Required
Bachelors degree in related field or equivalent experience
Five or more years of managed care or medical group experience, provider relations, quality improvement, utilization management, or clinical operations
Project management experience at a medical group, IPA, or health plan setting
Executive level exposure and ability to influence desired outcomes, innovation, performance, member improvements, growth and Provider retention
Ability to synthesize complex issues at multiple organizational levels, externally and internally across multi-disciplinary teams
Highly proficient in HEDIS/Quality measures, cost and utilization
Ability to travel locally 4 days a week
Preferred
Master's Degree preferred in Public Health (MOH), Health Administration (MHA) or Business Administration (MBA)
Benefits
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Company
ARC Group
We provide insightful advice that drives better decision making by placing investment performance into perspective.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase