Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY

The provider engagement program is key to the overall growth of Community Health Choice. As a Provider Growth Account Manager, you will join a hungry, collaborative team, holding multiple meetings a day with providers while also utilizing creative outreach to engage the providers and grow our Medicaid products. The account manager's role will prospect and build relationships with assigned providers, leverage CRM (Salesforce.com) to capture and report on all activity and market feedback. Maintaining an organized calendar of prospect meetings and communicating proactively, both internally with colleagues and externally with providers to achieve KPIs, while also employing a growth mindset, experimenting with tactics to generate membership growth.

JOB SPECIFICATIONS 

  • Build, manage and maintain strong relationships with communities, select provider participants and associations to build trust and align work with the State and health plan priorities. Represent Community Health Choice at market meetings, forums, events, and conferences, as assigned.
  • Resolve member and/or provider issues while demonstrating an understanding of all Texas Medicaid & Medicare lines of business as they apply to managed care to facilitate marketing.
  • Coordinate complaint formal and informal events to open the door for growth, brand awareness, provider, member, and community education.
  • Engage select provider program participants with face-to-face and virtual visits. Track all activities, events, contacts, and relationship progress daily through internal systems and platforms.
  • Provide recommendations to leadership regarding sponsorship for special projects and subsequently, manage the end-to-end process.
  • Educate providers on general policies and procedures applicable to the delivery of care (e.g., regulatory, quality of care, health plan benefits and online tools and resources).
  • Actively contributes to achievement of departmental goals, as identified in
  • Departments annual business plan, including specific departmental processes.
  • improvement plans, and other duties as assigned.


QUALIFICATIONS:

  • Education/Specialized Training/Licensure: High School Diploma or Equivalent required.
  • Work Experience (Years and Area): 4 years relevant work experience of which: 2 (two) year of health care / plan or selling / marketing to providers.
  • account management experience
  • Experience with Salesforce
  • Proven record of prospecting
  • Software Proficiencies: Microsoft Suite, CRM
  • Outstanding verbal and written communication skills
  • Excellent interpersonal and customer service skills are required with the ability to develop and maintain a positive relationship with both external and internal stakeholders.
  • Builder mindset: we do not have the playbook and things are constantly evolving.

Application Instructions

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