HealthHelp - A WNS Company (www.HealthHelp.com), is the leader in the field of healthcare utilization and care management. We have gained this position by actively working to change out-of-date practices with a collaborative, non-denial based approach. Our methodology helps payors achieve a higher return on investment, gives providers education programs that better inform physicians, and ensures quality and safety for the patients needing treatment. HealthHelp’s innovative approach and strong IT capability in specialty benefits management means that staff will move healthcare forward when provided with evidence-based solutions and second opinions. HealthHelp's staff is comprised of healthcare professionals who make a difference every day. HealthHelp has a desire to fill their company with talented and innovative people who want a career path filled with success and personal growth. Our specialty benefits management services are broad and include, Cardiology, Oncology, Radiology, Radiation Therapy, Sleep Care, and Musculoskeletal Care. HealthHelp is headquartered in Houston, Texas.
Job Description
- Accountable for overall delivery against contractual terms with client, financial performance, client satisfaction and retention.
- Responsible for driving the initiatives/opportunities across all lines of business working closely with the clients and health plan leadership to lock down opportunities within the annual budget and/or CMS planning cycle
- Responsible for Program performance and monitoring. Should be able to identify trends, work with Program teams to ensure ROI, and quality and safety standards are met
- Responsible for coordinating and strategizing compelling business solutions for new opportunities with existing clients
- Manages the overall implementation process of new client accounts and program add-ons to existing accounts; within timelines and budgets
- Responsible for overall profitability, driving initiatives to manage operational costs
- Develops account management strategy plan to ensure client satisfaction and optimize profitability and growth.
- Manages client expectations, provides issue escalation pathways; documents and manages all client issues.
- Responsible for contract negotiation and closure
- Ability to lead and direct teams to ensure that client objectives are met
- Regularly reports project operational and financial status to Senior Management.
- Analyzing data independently to discover insights and trends that drive recommendations for clients. Leads the process of continuously improving program performance in areas that matter to the client
- Ensures all required reports are delivered to the client in a timely manner.
- Ability to lead design and/or enhance documentation, process flows, and training materials specific for use both internally by HealthHelp staff and externally by the Client.
- Understand the products/programs/services provided by HealthHelp.
- Participates in the HealthHelp Quality Management Program as required
- Adheres to all HIPAA, state and federal regulations pertaining to the clinical programs
- Adheres to both URAC & NCQA standards pertinent to their job description
- 5+ year of experience in managed care/ utilization management, preferred
- 5+ year of experience with Medicare and Medicaid regulations, preferred
- Bachelor’s Degree in Business or Health Administration, preferred
- Minimum of five years of executive level account management and contract negotiation experience, required
- Demonstrates strong leadership skills to facilitate cooperation and project management among cross-functional teams and clients.
- Excellent interpersonal and customer service skills, with the ability to communicate efficiently with individuals at all seniority or C-Suite levels
- P&L management experience preferred
- Strong analytical and critical thinking skills. Ability to obtain, manipulate, and interpret various reports and data to produce meaningful information
- Should be reliable and trustworthy; should be detail oriented and organized in approach
- Proven project management, task management and execution management skills
- Experience working in cross functional and matrixed management operating teams
- Possess excellent organization and time-management skills to effectively prioritize and manage multiple competing priorities in a fast-paced environment.
HealthHelp provides equal opportunities to all employees and applicants without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws. If you need assistance in completing this application due to a disability, please contact a member of the Talent Acquisition Group to request an accommodation or an alternative application process by emailing talent@healthhelp.com
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Seniority level
Mid-Senior level -
Employment type
Full-time -
Job function
Health Care Provider -
Industries
Outsourcing/Offshoring
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