Provider Network Account Executive I Position Available In Hillsborough, New Hampshire

Your career starts now. We’re looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation’s leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we’d like to hear from you. Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

• Position Overview:

• The AE I is responsible for fostering and maintaining positive relationships between the Plan and its contracted providers. This includes managing accounts that may span single or multiple practices, locations, integrated delivery systems, or other provider organizations.

• Key Responsibilities:

• + ;Understand and manage the Plan’s contracts and provider performance, conduct tailored orientation sessions, educational visits, and resolve issues.

+ Ensure appropriate access to services across the Plan’s territory in compliance with state and federal mandates. + Identify, contact, and solicit qualified providers to join the Plan, ensuring financial integrity and adherence to contract requirements. + Use Plan reports and metrics to assess provider performance, communicate improvement plans, and enhance relationships. + Assist in implementing corrective actions, including termination, as per the Plan policies. + Aid in credentialing, re-credentialing, investigating member complaints, and addressing quality issues. + Maintain knowledge of Facets and relay information about provider changes to the Provider Maintenance Department. + Deliver accurate and timely activity and metric reports. + Build strong partnerships with internal resources and stakeholders.

• Education & Experience:

• + Bachelor’s degree or equivalent experience, high school diploma/GED + 1 to 3 years in Provider Services + 3 to 5 years in managed care/health insurance. + Experience with Medicare, Medicaid, or Exchange, behavioral health, contract negotiations, value-based contracting, and provider auditing. + Independent work, relationship building, training facilitation, priority setting, problem-solving. +

• Travel:

• The position requires 25% to 50% travel in New Hampshire. ;Qualified candidate must be located in New Hampshire.; A valid driver’s license and automobile insurance are required. ;
• Diversity, Equity, and Inclusion
• At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves.

Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.; We keep our associates happy so they can focus on keeping our members healthy.

• Our Comprehensive Benefits Package
• Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays, and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.

As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.