Provider Engagement Account Executive - Hybrid, NY

Role is Hybrid, but will need to go into the field to meet with Providers 30% - 50%

• Queens, NY, US
• The Bronx, NY, US

Join a leading national organization dedicated to transforming the health of communities, one person at a time. This organization is at the forefront of healthcare innovation, committed to delivering high-quality care and improving member outcomes across the nation.

As a vital partner, you will play a pivotal role in fostering strategic relationships and driving performance improvements that directly impact millions of lives. Your work will not only shape the future of healthcare delivery but also ensure our members receive the highest level of care. This dynamic and engaging role is perfect for a passionate individual ready to make a significant difference. You will be instrumental in developing strategic partnerships with healthcare providers, cultivating strong client relations, and collaborating closely to enhance patient care. By focusing on value-based care models and leveraging data analytics, you will empower providers to optimize care delivery, achieve better patient outcomes, and contribute to a more efficient and effective healthcare system.

If you thrive on building relationships, driving performance, and contributing to a healthier future, this is your opportunity to shine.

Responsibilities:

• Conduct 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.
• Drive value-based care model initiatives, collaborating with physicians to identify and align performance-based agreements that incentivize better patient outcomes, cost-efficiency, and quality care.
• Utilize data analytics to track and monitor provider performance, offering actionable feedback to help physicians optimize care delivery and meet key performance targets.
• Build strong interpersonal relationships with cross-functional teams, both externally with providers (including C-suite level) and internally within the health plan.
• Demonstrate expert proficiency in tools and value-based performance (VBP) to educate providers, resulting in improved performance.
• Resolve provider issues, escalating as needed to internal partners and implementing efficiencies to prevent recurring concerns.
• Effectively respond to and resolve external provider-related issues.
• Investigate, resolve, and communicate high-dollar and high-volume provider claim issues and changes.
• Educate providers regarding policies and procedures related to referrals, claims submission, web site usage, and electronic data interchange (EDI) solicitation.
• Evaluate provider performance and develop strategic plans for improvement.
• Present detailed analysis and create reports for Joint Operating Committee meetings (JOC).
• Act as a lead for external representatives, coaching and training them.
• Ability to travel locally 4 days a week.

Must-Have Qualifications:

• Bachelor's degree in a 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.
• Proven experience conducting face-to-face meetings with providers specifically to discuss performance metrics and identify improvement opportunities in patient care and clinical practices.
• Executive-level exposure and demonstrated 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 quality measures, cost, and utilization.
• Valid Driver's License.

Nice-to-Have Qualifications:

• Master's Degree in Public Health (MOH), Health Administration (MHA), or Business Administration (MBA).
• Project management experience at a medical group, IPA, or health plan setting.
• The target hiring compensation range for this role is $115,000.00 - $120,000.00 per year. Potential annual bonus of 8% based on company hitting annual performance goals.

About Aquent Talent: Aquent Talent connects the best talent in marketing, creative, and design with the world's biggest brands. Our eligible talent get access to amazing benefits like subsidized health, vision, and dental plans, paid sick leave, and retirement plans with a match. More information on our awesome benefits! Aquent is an equal-opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics. We're about creating an inclusive environment-one where different backgrounds, experiences, and perspectives are valued, and everyone can contribute, grow their careers, and thrive. The target hiring compensation range for this role is $115,000.00 to $120,000.00. Compensation is based on several factors, including, but not limited to, education, relevant work experience, relevant certifications, and location.