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Payer Account Manager, Managed Care at Visiting Nurse Service of New York

Posted in Other 30 days ago.

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Type: Full Time
Location: Manhattan, New York

Job Description:

OVERVIEW

Visiting Nurse Service of New York (VNSNY) is the nation s largest not-for-profit community-based health system. VNSNY provides a comprehensive array of home- and community-based programs, including health plans, tailored to the needs of high-risk, vulnerable New Yorkers, improving their quality of life. Each day,more than 13,000 VNSNY employees including nurses, rehabilitation therapists, social workers, other allied professionals, and paraprofessionals deliver compassionate care, unparalleled medical expertise, and 24/7 solutions and resources tomore than48,000 patients and health plan members, helping them to live the best lives possible.

RESPONSIBILITIES

Manages all aspects of specified accounts and achieving established goals. This includes the developing, planning, organizing, implementing, directing and evaluating the marketing plans and ongoing client relations activities for managed care accounts. Responsible for planning, developing and managing projects related to new product and initiatives. Works under general direction.

* Develops best practices to maximize opportunities and service clients, including profiling accounts, identifying managed care needs and developing relationships with managed care payers.

* Researches and identifies new business opportunities.

* Maintains ongoing contact with VNSNY key staff as it relates to servicing managed care companies.

* Serves as liaison between managed care companies and VNSNY staff in the coordination of the delivery of high-quality home care services.

* Collaborates with managed care leadership and managed care companies in developing and implementing strategies for improving the efficiency and effectiveness of the agreements and care in conjunction with VNSNY goals.

* Works with managed care leadership, VNSNY staff, and managed care companies in developing and managing the pre certification and verification process. Defines, develops and expands needed services and programs to ensure optimum service to clients.

* Directs the reporting and assesses the results and status of the payers on an ongoing basis to achieve VNSNY goals.

* Coordinates client activities with appropriate VNSNY staff, developing and strengthening role as key resource for both client and internal contacts.

* Develops and maintains effective and positive working relationships with client and applicable VNSNY staff by fostering open and ongoing communication and follow-up procedures to ensure both client and VNSNY needs are met.

* Interprets VNSNY policies and procedures for managed care companies.

* Assumes lead role in maintaining ongoing contact with key staff in current and potential new accounts through making presentations, securing client agreements to work with VNSNY, conducting ongoing visits and maintaining comprehensive documentation, in conjunction with VNSNY directives.

* Cultivates effective and positive working relationships with clients' key decision-making staff. Positions VNSNY at decision making level to further enhance ability to provide new and expanded services.

* Works independently in handling internal/external client situations by utilizing effective problem solving skills, addressing client concerns, providing thorough follow-through, and in all cases consistently providing excellent customer service.

* Participates in special projects and performs other related duties, as required.

Education: Bachelors Degree or equivalent work experience is required. Masters degree in Business Administration is preferred.

Experience: Minimum of four years of progressive experience in sales or marketing with demonstrated ability to develop and maintain effective customer client relationships is required. Minimum of two years marketing or sales experience in health care industry is preferred. Excellent analytical, project management and presentation skills required. Knowledge and understanding of Medicare and Medicaid regulations required. Experience working in home health care and managed care operations is preferred.

CA2018

VNSNY is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, national origin, disability or protected veteran status. If you would like more information about your EEO rights, then please visit:

http://www.vnsny.org/system/assets/0000/3510/eeopost.original.pdf?1394816984