Job Details

Requisition Number 18-1799
Post Date 10/25/2018
Title Health Partner Manager
City Cleveland
State OH
Description

Role and Responsibility:

§  Achieve expert level knowledge and relationships within the targeted community while informing, driving and creating awareness around targeted communities within CareSource.

§  Develop and provide proactive, high-level account support and enhance relationship to key CareSource health partner(s) within assigned community

§  Demonstrate ability to stratify health partners based on their ability to deliver quality outcomes and access to our consumers.  Develop and execute action plans to improve each health partner’s performance.

§  Monitor and manage the achievement of health partner’s specific performance guarantees to include but not limited to operations, clinical, pharmacy, and behavioral health.

§  Exhibit continual health partner focus by thoroughly understand needs, concerns and priorities.  Manage expectations internally and externally and find ways to add value

§  Act as a champion for the health partner and demonstrate the ability to handle, refer, or delegate complex or non-routine questions, issues, and problems to appropriate resources and ensure timely resolution

§  Collaborate with cross functionally in the development of health partner specific strategies for enhanced engagement including collaboration with HRCM and Community Education Representatives.

§  Monitor the ongoing health partner’s experience and ensure that internal resources are able to resolve problems effectively and timely resulting in a satisfied health partners’ experience

§  Refer routine health partner service issues, administrative functions, eligibility, and claims questions to appropriate internal departments

§  Ensure  management  informed of health partner’s status,  opportunities for relationship enhancement and unresolved systemic issues

§  Identify internal procedures that adversely affect health partner’s satisfaction and collaborate with internal areas to build consensus and to initiate and implement improvements

§  Facilitate and or be an active participant in all necessary meetings related to health partner engagement, quality and performance

§  Influence the renegotiation of contracts utilizing detailed analysis of health partner behaviors in an effort to drive business priorities.

§  Active involvement in community boards, groups and or committees related to community engagement, quality and performance.

§  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

Requirements

Education / Experience:

§  Bachelor’s Degree in  Sales/Marketing, Communications, Business or related field or equivalent years of relevant work experience is required

§  Five (5) or more years of healthcare industry, account management or sales experience, or equivalent experience obtained via a Master’s degree with an emphasis on Healthcare Administration, is required

Required Competencies / Knowledge / Skills:

§  Proficient in Microsoft Office Suite to include Word, Excel, Outlook

§  Knowledge of managed care principles, benefit design, claims processing, finance, data reporting design, and analysis

§  Proven leadership and mentoring experiences

§  Effective listening and critical thinking skills

§  Strong problem solving skills with attention to detail

§  Excellent written and verbal communication skills and presentation skills

§  Excellent organizational and time management skills

§  Ability to develop, prioritize and accomplish goals

§  Strong interpersonal skills and high level of professionalism

§  Demonstrated strategic thinking and planning skills

§  Excellent research and analytical skills

§  Marketing competencies

§  Proven project management skills

Licensure / 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  you have started employment in this position, your employment in this position will be terminated

Accountability:

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.

§  Reside in the same territory they are assigned to work in ; exceptions may be considered, due to business need

§  May be required to travel greater than 50% of time to perform work duties.  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 member and may refer members to other CareSource resources

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