Delegation Oversight Account Manager II
Los Angeles, CA (Remote)
4+ Month Contract
Job ID 2024-9989
Solugenix is assisting a client, a prestigious health insurance company, in their search for a Delegation Oversight Account Manager II. This is a 4+ month contract opportunity based out of Los Angeles, CA (Remote).
The Delegation Oversight Account Manager II will serve as the single point of contact between the client and its contracted entities as it relates to delegate performance. The Account & Communications Manager II will be assigned up to four delegate accounts and will be responsible for facilitating the collection of performance-related data, following up on outstanding data, facilitating annual audit processes, triaging notices of non-compliance, and executing the internal and delegate communications strategy. Assigned accounts include large provider organizations (i.e. PPGs, Specialty Health Plans, etc.) or partnering health plans. The Account & Communications Manager II is responsible for maintaining the relationship between the client and its delegates about performance and will streamline all communications from business units to delegates. It will maintain a repository of communications to ensure consistency and will triage delegate communications as they relate to performance metrics and standards. The Account & Communications Manager II will regularly meet and coordinate with internal business units to ensure accuracy in communications and warm transfer of information.
Qualifications Required:
- Bachelor's Degree, instead of degree, equivalent education and/or experience may be considered.
- Master's Degree – Preferred.
- At least 3-5 years of experience in provider relations, account management, or relationship management in the managed care or healthcare industry.
- At least 3 years of healthcare experience in Managed Care; or, with a physician group, clinical-based organization, and/or in a hospital/facility setting.
- Proven ability to work with a diverse group of people, including physicians, support staff, coworkers, and management.
- Demonstrated ability to research issues and bring about resolution either directly or with the assistance of others.
Responsibilities:
- Executes a single point of contact communication and account management strategy for all delegates as it relates to performance. Serves as a communication link between assigned accounts and client.
- Completes regularly scheduled meetings (site visits, or conference calls) with all accounts. Translate information exchange, ideas, requests, and other inquiries into actionable items for improved relationship management and enhanced performance.
- Responsible for the project management facilitation and collection of monitoring, reporting, and audit activities and will liaise with business units and auditors in the coordination of each activity.
- Serves as the conduit through which all communications flow between business units and their counterparts at delegated entities. Conduct internal monthly meetings with stakeholders reviewing delegate performance.
- Implements communication protocols to ensure all delegates are consistently and uniformly informed of client’s expectations and their performance. Delivers accurate, timely, and appropriate information to their assigned accounts and maintains a repository of all communications.
- Communicates to delegates will include but not be limited to 1. Data submissions, 2. Monitoring results, 3. Audit Results, 4. Remediation Efforts, 5. CAP Statuses, 6. Sanctions decisions, 7. Delegate responses and updates.
- Drafts and sends monthly delegate newsletters for performance information impacting all delegates and celebrating high-performing delegates.
- Maintains an understanding of client's reports and metrics to evaluate the performance of assigned providers and/or provider organizations and uses the data to develop and implement methods to improve relationships with all providers. Assists in all corrective actions required, up to and including termination, following client policies and procedures, and applicable contractual and regulatory requirements.
- Performs other duties as assigned.
Pay Range for CA, CO, IL, NJ, NY, WA, and DC: $37.51/hour to $48.29/hour. Starting rate of pay offered may vary depending on factors including but not limited to, position offered, location, education, training, and/or experience.
About the Client
Our client is one of the world's leading health insurance company based out of Los Angeles, CA.
About Solugenix:
Solugenix is an information technology services company known for its deep experience and knowledge in providing comprehensive technology services, solutions, and talent support for companies around the world. The company offers a variety of cutting edge and talent support solutions to promote growth and cutting-edge advancement to our esteemed clients and candidates. We provide these talent support solutions on a contract, contract-to-hire, and direct hire basis. We also have additional resources from our staffing partners to ensure the right match and expertise for the best result.
For over 50 years, global and local brands have trusted Solugenix as an added resource and partner in taking steps to ensure their immediate and future success. In addition to generating ground-breaking, industry-defining solutions, Solugenix has been delivering the talent and support needed to make it happen. We are dedicated to partnering with clients and candidates whose core values also foster a culture of professionalism, teamwork, and integrity.
