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AmeriHealth Caritas · 1 week ago

Provider Network Account Executive

Manchester, NH

Full-time

Hybrid

Mid Level

3+ years exp

AmeriHealth Caritas is seeking a detail-oriented and relationship-driven Account Executive I to manage and support their network of contracted healthcare providers. The role involves building partnerships, conducting orientations, resolving issues, and ensuring compliance with access requirements.

Health CareInformation Technology

H1B Sponsor Likely

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

Utilize plan reports and metrics to evaluate provider performance, communicate improvement plans, and foster stronger 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

Qualification

Provider services experienceManaged care experienceContract negotiationsMedicare experienceMedicaid experienceValue-based contractingProvider auditingRelationship managementTime managementCross-functional teamwork

Required

Bachelor's degree or equivalent experience, high school diploma/GED required

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

Must have a valid driver's license and car insurance

Establish and maintain trust-based partnerships with healthcare providers and internal teams

Manage and de-escalate provider concerns or issues with professionalism and diplomacy

Take initiative, manage time effectively, and complete tasks with minimal supervision

Balance competing demands across provider accounts, projects, and deadlines

Work effectively with cross-functional teams within internal departments

Company

AmeriHealth Caritas

Glassdoor3.4

AmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill.

Founded in 1982

Philadelphia, Pennsylvania, USA

10001+ employees

http://www.amerihealthcaritas.com

H1B Sponsorship

AmeriHealth Caritas has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (18)

2024 (17)

2023 (12)

2022 (14)

2021 (4)

2020 (11)