Enlightened, Inc · 1 day ago
Provider Network Account Executive
Washington, DC, US
Full-time
Hybrid
Senior Level
$80K/yr - $90K/yr
5+ years expEnlightened, Inc is one of the Washington Metropolitan-area’s fastest growing IT companies, and they are seeking a Provider Network Account Executive. The role is responsible for building and maintaining relationships between the Plan and its contracted providers, managing the provider network, and ensuring compliance with State and Federal mandates.
Information Technology
Responsibilities
Works with providers that have complex or higher numbers of multiple practice locations and multi-specialty practices and multiple providers
Manages a total provider practice annual pay amount over $1M
Engages with those that impact a total member population of a minimum of 5,000 or more. The appropriate minimum number of member population impact for the Network Executive II level is determined by each Plan according to their business environments
Responsible for managing an ongoing Provider Network Management organization project or program
Develops, implements, and manages programs and projects that support or impact high dollar and high member provider groups
Participates in or independently develops and implements Provider Network education programs and materials (both internal and provider-targeted) and is assigned to train, mentor, and support new Network Executives (NEs)
Qualification
Required
Bachelor's Degree
3 to 5 years of experience in a Provider Services position working with providers
5 to 10 years of experience in the managed care/health insurance industry with demonstrated strengths in: knowledge of Plan policies and procedures related to provider contracting, provider credentialing, provider billing and payment, provider incentive programs, and other key State and Federal regulatory requirements related to providers; claim adjudication systems; provider file database requirements; and relevant software applications; working independently and managing complex projects and programs both as an independent owner and team leader; training and mentoring skills; and interacting at an executive level both internally and externally
Substantive Account Executive experience with high impact, high dollar, extremely visible, and critical provider groups
Medicaid experience required
Strong leadership skills and ability to navigate change
Ability to work cross-functionally, problem-solve, and navigate efficiently through bureaucracy
Working knowledge and proficiency with Microsoft Office products
Ability to manipulate spreadsheets and data in Microsoft Excel
Excellent listening skills
Strong verbal and written communication skills
Detail-oriented with strong organizational and time management skills
Self-motivated
Scheduling, planning, and follow-up skills
Ability to interface effectively with a diverse population
Ability to work independently and with teams
Broad knowledge about the community, specific health issues, and health and social service systems
Benefits
Medical/Dental/Vision Insurance with Health Savings Accounts (HSA)
Flexible Spending Accounts (FSA)
401(k) Retirement Plan
Paid Holidays, Vacation, & Sick Leave
Professional Training & Development Reimbursement
Company
Enlightened, Inc
Enlightened, Inc. is an award-winning, information technology (IT) consulting firm headquartered in Washington, DC.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Antwanye Ford
Co-Founder, CEO & President
Recent News
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2023-09-13
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