СШАDirector of Account Management
4 нед. назад
140k–150k USD / годСШАDirectorRemote
Lead and grow health plan partnerships ensuring successful adoption and expansion of 's core CalAIM healthcare programs.
Обязанности
- As the Director of Account Management, you will build and lead the success, growth, and retention of our health plan partnerships. A key focus of this role is ensuring clients achieve measurable outcomes through the successful adoption and expansion of ’s core CalAIM lines of business - Enhanced Care Management (ECM) and Community Supports (CS) - along with our active California Integrated Care Management (CICM) partnerships.
- This role combines strategic partnership leadership and growth accountability. You will guide account strategy, ensure successful delivery across complex value-based healthcare partnerships, and drive portfolio growth through renewals, expansions and strong client outcomes. Deep working knowledge of Medi-Cal managed care contracting and CalAIM benefit categories is essential. The Manager of Account Management acts as both senior relationship lead and internal orchestrator, ensuring cross-functional teams deliver measurable value for clients while maintaining strong financial performance.
- Kindly note we are only considering applicants in California at this time.
Требования
- Bachelor's degree in Healthcare Administration, Business Administration, or a related field required; advanced degree (MBA, MHA, or similar) preferred.
- 10+ years of experience in account management, client partnerships, or strategic client success working with organizations servicing health plans in government-sponsored lines of business, including 5+ years with managed Medicaid and CalAIM.
- Direct working knowledge of Enhanced Care Management (ECM) required; familiarity with California Integrated Care Management (CICM) and Community Supports (CS) highly preferred.
- Experience partnering with health plans, value-based care organizations, health systems, and community-based provider networks, including ECM Lead Entities.
- Strong understanding of Medi-Cal managed care contracting, DHCS requirements, and CalAIM policy guides.
- Strong commercial acumen, including experience with contracts, pricing models, and margin management.
- Track record of managing a high-value client portfolio, with measurable success in retention and partnership expansion.
- Exceptional interpersonal and executive communication skills with the ability to build trusted relationships across clinical, operational, and executive stakeholders.
- Working knowledge of healthcare regulatory and compliance standards, including HIPAA and other requirements relevant to payer and provider partnerships.
- Experience using CRM platforms and reporting tools to monitor client performance, pipeline, and account health. Hubspot experience is highly preferred.
- Willingness and ability to travel up to 25% for client meetings and team collaboration.
Другое
- Join the dynamic journey at , where we're passionate about transforming care for individuals with complex needs. We’re more than just a team; we're a close-knit community. Our shared commitment to caring for each other and those we serve is what sets us apart. Guided by our unwavering core values: Excellence, Compassion, Curiosity, and Integrity, we forge paths of success together. Join us in this transformative movement where you can contribute to making a profound difference every day. At , our mission is to provide comprehensive care for more quality days at home.
- Serve as the relationship owner for our value-based health plan partnerships
- Build trusted relationships across multiple stakeholders at the plan
- Understand client strategic priorities, population health goals, and success metrics
- Act as the primary advocate for client needs
- Ensure long-term client satisfaction, retention, and strategic alignment
- Establish and maintain scalable processes and playbooks for account management
- Drive successful adoption and performance of ECM and support other active partnerships
- Monitor performance against contracted metrics including Medi-Cal/DHCS requirements and CalAIM program deliverables for referral acceptance, member engagement, and care plan completion
- Owns the day-to-day relationship against the MSAs and contract terms (e.g., SLAs)
- Own revenue realization including contract renewals, rate negotiations and amendments
- Develop and own strategic account plans that identify risks, opportunities, and growth pathways
- Identify upsell and cross-sell opportunities as clients expand program adoption, including expansion into additional CalAIM Community Supports Programs.
- Forecast revenue and account health across the portfolio
- Lead Monthly or Quarterly Business Reviews with clients
- Monitor KPIs, SLAs, and operational outcomes, translating performance into business impact (ROI, savings, quality and growth)
- Track DHCS policy and CalAIM program changes and translate them into partner-facing guidance and account strategy
- Coordinates eligibility files, claims/encounter data exchange, and authorization workflows between systems
- Troubleshoots data discrepancies (enrollment mismatches, claims denials, encounter data rejections) and works with the health plan — often the most time-consuming part of the job
- Manages escalations when service delivery breaks down
- Understands how the health plan's quality and outcomes metrics and contracted quality incentive payments are measured and how quality incentive payments work
- Builds and delivers regular performance and quality dashboards
- Be conversant in the plan's own analytics
- Understands the regulatory environment and Medicaid managed care rules and state-specific mandates such as CalAIM in California
- Ensures the vendor's service delivery remains compliant with the plan's regulatory obligations
- Acts as the internal voice of the client
- Coordinates internally across internal teams: clinical, IT/data, finance, and legal to solve plan issues
- Often the first to sense contract risk and must escalate internally before it becomes a retention crisis
- The hiring process for this role may consist of applying, followed by a phone screen, online assessment(s), interview(s), an offer, and background/reference checks.
- Background Screening: A background check, which may include a drug test or other health screenings depending on the role, will be required prior to employment.
- Job Description Scope: This job description is not exhaustive and may include additional activities, duties, and responsibilities not listed herein.
- Vaccination Requirement: Employees in patient, client, or customer-facing roles must be vaccinated against influenza. Requests for religious or medical accommodations will be considered but may not always be approved.
- Employment Eligibility: Compliance with federal law requires identity and work eligibility verification using E-Verify upon hire.
- Environmental Conditions and Physical Requirements: Works with patients/clients remotely and/or in-person. Successfully performs the essential duties and responsibilities of the position through the use of physical activities as described below: Regularly requires sitting, standing, walking, talking, use of hands, listening, and observing.
- Regularly requires working at a computer for an entire shift (with appropriate breaks).
- Regularly requires use of laptop and video-conferencing technology.
- Occasionally requires reaching, stooping, bending, kneeling, and lifting items weighing 25 pounds or less.
- Occasional travel may be required to perform job duties, attend training, or company events.