CareSource
Health Partner Engagement Specialist II-Healthcare Account Managment Experience-
CareSource, Nevada, Iowa, United States, 50201
Health Partner Engagement Specialist II - Healthcare Account Management Experience - Northern Nevada - R9508
Job Summary: The Health Partner Engagement Specialist II collaborates with key Health Partners in the development of specific strategies for enhanced engagements. Health Partner engagement shall be measured by confidence in CareSource and affiliated Companies’ ability to fulfill promises, integrity to make things right when problems occur, pride in working with CareSource, and their passion about CareSource being a vital member of the care team.
Essential Functions
Provide proactive, high-level account development and support in order to drive the overall satisfaction and engagement of key Health Partners
Achieve the team business plan objectives, both in implementing new plans and in identifying and responding to customer needs
Develop strong working relationships with key internal business partners
Demonstrate the ability to handle, refer, or delegate complex or non-routine questions, issues, and problems to appropriate resources as they relate to the assigned accounts and ensure they are resolved in a timely manner. Timely is defined as 30 days or less.
Refer routine Health Partner service issues, administrative functions, eligibility, and claims questions to appropriate internal departments
Make on-site presentations to existing and prospective clients to educate and inform on CareSource products and report on key operational metrics
Keep management informed of account status & opportunities for relationship enhancement & unresolved systemic issues
Monitor and manage the achievement of customer specific performance guarantees to include operations, clinical, pharmacy, behavioral
Identify internal procedures that adversely affect customer satisfaction and work with internal areas to build consensus to initiate improvements
Maintain organized files & document all interactions in the Customer Relationship Management tool (CRM)
Coordinate with Clinical Practice Consultant and Case Management counterparts to ensure seamless service and consistent training
Set targets and priorities in order to contribute towards meeting overall CareSource Network Strategy
Support recruitment and contracting efforts by developing strong interpersonal relationships with providers, hospitals and ancillary providers
Participate in the renegotiation of contracts utilizing detailed analysis of provider behaviors
Facilitate and/or participate in all necessary committees and groups related to Health Partner engagement, quality and performance
Perform all necessary duties to successfully support CareSource and Affiliate Companies contractual requirements with state and any other regulatory entities
Regular travel to conduct health partner visits and community-based visits as needed to ensure effective administration of the program
Perform any other job related instructions, as requested
Education And Experience
Bachelor of science/arts degree in communications, business or related industry or equivalent years of relevant work experience is required
Master Degree preferred
Five or more years of healthcare industry, account management or sales experience
Demonstrated ability to develop and grow relationships in complex healthcare organizations
Competencies, Knowledge And Skills
Proven relationship development skills
Strong proficiency level with Microsoft Word, Excel, Outlook
Knowledge of managed care principles, benefit design, claims processing, finance, data reporting design, and analysis
Proven leadership and mentoring experiences
Strong written and verbal communication and presentation skills
Excellent organizational and time management skills
Ability to prioritize
Strong interpersonal skills
Demonstrated strategic thinking and planning skills
Excellent research and analytical skills
Marketing competencies
Licensure And Certification
Employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated.
Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have 30 days from their hire date to complete the required vaccination and have record of immunization verified.
CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.
Working Conditions
Mobile Worker: This is a mobile position, meaning that regular travel to different work locations is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time.
Residency in the same territory as the assigned work area; exceptions may be considered due to business need
May be required to travel greater than 50% of the time. A valid driver’s license, car, and insurance are necessary for work-related travel
Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer
Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members
Compensation Compensation Range: $61,500.00 - $98,400.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type Salary
Disclaimer This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
Note: The original description contained additional job postings and references that are not relevant to this specific role and have been removed to maintain focus on the Health Partner Engagement Specialist II responsibilities and requirements.
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Essential Functions
Provide proactive, high-level account development and support in order to drive the overall satisfaction and engagement of key Health Partners
Achieve the team business plan objectives, both in implementing new plans and in identifying and responding to customer needs
Develop strong working relationships with key internal business partners
Demonstrate the ability to handle, refer, or delegate complex or non-routine questions, issues, and problems to appropriate resources as they relate to the assigned accounts and ensure they are resolved in a timely manner. Timely is defined as 30 days or less.
Refer routine Health Partner service issues, administrative functions, eligibility, and claims questions to appropriate internal departments
Make on-site presentations to existing and prospective clients to educate and inform on CareSource products and report on key operational metrics
Keep management informed of account status & opportunities for relationship enhancement & unresolved systemic issues
Monitor and manage the achievement of customer specific performance guarantees to include operations, clinical, pharmacy, behavioral
Identify internal procedures that adversely affect customer satisfaction and work with internal areas to build consensus to initiate improvements
Maintain organized files & document all interactions in the Customer Relationship Management tool (CRM)
Coordinate with Clinical Practice Consultant and Case Management counterparts to ensure seamless service and consistent training
Set targets and priorities in order to contribute towards meeting overall CareSource Network Strategy
Support recruitment and contracting efforts by developing strong interpersonal relationships with providers, hospitals and ancillary providers
Participate in the renegotiation of contracts utilizing detailed analysis of provider behaviors
Facilitate and/or participate in all necessary committees and groups related to Health Partner engagement, quality and performance
Perform all necessary duties to successfully support CareSource and Affiliate Companies contractual requirements with state and any other regulatory entities
Regular travel to conduct health partner visits and community-based visits as needed to ensure effective administration of the program
Perform any other job related instructions, as requested
Education And Experience
Bachelor of science/arts degree in communications, business or related industry or equivalent years of relevant work experience is required
Master Degree preferred
Five or more years of healthcare industry, account management or sales experience
Demonstrated ability to develop and grow relationships in complex healthcare organizations
Competencies, Knowledge And Skills
Proven relationship development skills
Strong proficiency level with Microsoft Word, Excel, Outlook
Knowledge of managed care principles, benefit design, claims processing, finance, data reporting design, and analysis
Proven leadership and mentoring experiences
Strong written and verbal communication and presentation skills
Excellent organizational and time management skills
Ability to prioritize
Strong interpersonal skills
Demonstrated strategic thinking and planning skills
Excellent research and analytical skills
Marketing competencies
Licensure And Certification
Employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated.
Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have 30 days from their hire date to complete the required vaccination and have record of immunization verified.
CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.
Working Conditions
Mobile Worker: This is a mobile position, meaning that regular travel to different work locations is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time.
Residency in the same territory as the assigned work area; exceptions may be considered due to business need
May be required to travel greater than 50% of the time. A valid driver’s license, car, and insurance are necessary for work-related travel
Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer
Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members
Compensation Compensation Range: $61,500.00 - $98,400.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type Salary
Disclaimer This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
Note: The original description contained additional job postings and references that are not relevant to this specific role and have been removed to maintain focus on the Health Partner Engagement Specialist II responsibilities and requirements.
#J-18808-Ljbffr