Now Hiring - Longevity Health Plan of Illinois, Inc. - Healthcare Account Manager in Boston, MA

Full description of the position

Company Overview

Longevity Health Plan Statement of Purpose: To improve the health and quality of life of nursing home residents by caring for their unique medical, social and emotional needs

Longevity Health Plan is a Medicare Advantage Institutional Special Needs Health Plan (ISNP) for long-term nursing home residents. Longevity Health Plan covers all medically necessary and preventive services covered under Medicare Part A (Hospitalization) and Part B (Medical), and Part D (Prescription Drug). We’re focused on improving our members’ physical, mental, and social well-being through personalized clinical care and therapies.

Longevity Health Plan is growing rapidly and is looking to add new talent to our team. Longevity Health Plan currently has operations in Colorado, Florida, Illinois, Michigan, New Jersey, New York, and North Carolina, with plans to start-up operations in additional states in the very near future. Due to our rapid growth, we have an immediate need for an Account Manager to support our Massachusetts Market.

Position Summary
The Account Manager is responsible for coordinating implementation of ISNP program for assigned facilities including coordinating and presenting at cross functional meetings with executive through line staff. The Account Manager is the main point person of contact for their facilities and will coordinate activities of /and be supported by Network, Clinical, and Project Management teams in the organization. Account Manager is responsible for communicating all enrollment, clinical, and quality targets for their facilities and works collaboratively with other departments to achieve these goals.

Essential Functions

• Establish facility specific strategy and enrollment goals then lead implementation workplan for assigned facilities and be responsible for the ongoing management of ISNP product at the assigned facilities including their relationship with network providers.
• Main point of contact between facility and plan. Collaborate with facility management and staff to ensure quality services are provided to members and plan administrative functions are carried out effectively.
• Identify and resolve operational issues between plan and facility and coordinate implementation of solutions to prevent future issues.
• Support ongoing cost reduction or contract and relationship maximization with service providers. This includes facilities, individuals, networks, using a diverse range of techniques and contracting ''best practices'', including capitation, case rates, and various fee for services arrangements.
• Execute and manage multiple facility expansion related priorities for Plan.
• Collaborate with Provider, Network, and Contracting team in the development of the region-wide contracting strategy then support the management and implementation as required. This includes specialty services and the alignment of contract interests of Plan and Network providers.
• Manage contractual relationships and ensure accurate administration of contract terms. Lead and participate in multidisciplinary teams comprised of contracted provider representatives.
• Provide ongoing intervention and assistance in the management of claims, UM and benefit issues.
• Collaborate with Finance and Performance Analysis teams to identify cost savings initiatives and monitor contract performance.
• Ensure contract compliance with all requirements as set forth by State and Federal agencies.
• Supervise and execute special projects as assigned.
• Support organization's strict adherence to the Company's Compliance Plan and Standards of Conduct with emphasis on compliance with established procedures and protocol, internal controls, and maintaining the highest level of workplace behavior.
• Review and assist in creation and maintaining operational policies and procedures that support organizational improvements and comply with federal and state requirements.
• Enforce policies and programs that encourage employees and related entities to report suspected fraud and other improprieties without fear of retaliation.
• Support the compliance program in identifying and responding to compliance deficiencies and corrective action plan.
• Performs other related duties as assigned.

Licensure

• Valid Driver's License and Proof of Automobile Insurance.

Education and Training

• Bachelor’s degree or equivalent.

Knowledge and Experience

• Relevant Work Experience: 3 plus years of healthcare industry experience with focus on provider relations, contracting, and business development.
• Excellent communication and presentation skills to all levels of staff and management.
• Strong project management and coordination skills.

Candidates must meet the Company’s hiring criteria which include a pre-employment background and drug screening.

Due to the requirement for employees in this role to enter nursing homes and be in close proximity to the most vulnerable of our population, it is required that the individuals in this role be 100% vaccinated for COVID-19 and receive the booster vaccinations as they become available.

Longevity Health Plan is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Longevity Health Plan offers competitive compensation and benefits package which includes medical, dental, vision, short and long-term disability, life insurance, and 401(k).

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Supplemental pay types:

• Bonus pay

Application Question(s):

• What is your desired salary?
• Are you fully vaccinated for COVID-19?

Education:

• Bachelor's (Required)

Experience:

• Account management: 3 years (Preferred)
• Healthcare with provider relations: 3 years (Required)
• Project management: 1 year (Required)

Work Location: On the road