Managed Care Sales Manager
8 - 10 years experience • Managed Care & Health Insurance
SUMMARY: The Managed Care Sales Manager serves as an effective liaison between William Demant Group companies, network providers, managed care organizations, partners and other referral sources. The Managed Care Sales Manager will exhibit customer service excellence, demonstrate innovation in developing methods to position DGS to positively grow within the hearing healthcare environment and create positive outcomes for its providers, hearing impaired customers and Managed Care partners. He/She will proactively work to build strategic relationships with payers and network providers in areas such as hearing care services and sales within Managed Care programs, HMO’s, PPO’s, TPA’s, Government programs, Unions and other related Managed Care opportunities.
The YHN Managed Care Sales Manager will provide support to DGS and its partners related to network management, reporting, contract management, best practices, and liaison support to ensure the best operational and financial outcomes. He/She will identify needs and growth opportunities within Managed Care organizations and present proposals for solutions to create positive outcomes for the network membership and payers alike.
KEY RESPONSIBILITIES (including but not limited to):
- Focus on sales related activates to grow hearing aid sales through Managed Care payers.
- Stay abreast of regulations, trends, and expectations related to hearing care.
- Maintain a thorough knowledge of all aspects of network provider’s and payers’ strategies, policies, procedures and quality measures.
- Provide extraordinary customer service with members, network and payer relationships and with external contacts by exceeding expectations, providing effective and complete communication and creating positive resolution.
- Increase YHN provider member enrollment, network and payer relationships through regular and essential communication. Be proactive in creating opportunities for providers and in generating positive solutions on both provider and payer’s behalf.
- Act as liaison, negotiator, and mediator between DGS and Your Hearing Network (YHN) and payer entities to create positive outcomes for both.
- Focus on methods to improve finances, data collection and other applicable operations where necessary.
- Manages the overall contract negotiation process with managed care organizations using an analytical approach.
- Attends trade shows, managed care meetings, and conventions
- Research areas that impact YHN process, direction, strategy and results to produce current data, new ideas, and growth opportunities.
- Utilize OneRetail software support for Managed Care accounts, contacts, agreements, tasks, opportunities, reporting, etc. to best manage and monitor network operations, goals and results.
- Analyze local, regional, state and national data and formulate improvement strategies and methodologies to help YHN to positively evolve under healthcare legislation and reform.
- Assist in managed care plan credentialing, billing and claim issues as needed
- Assist where needed with the credentialing function for the network, assuring accuracy and timeliness as needed.
- Support YHN marketing and branding efforts as needed.
- Assist in maintaining current database information, entries and sources.
- Provide updates and changes from research and other efforts to ensure current, relevant and required content for the YHN websites.
- Participate as directed in special and routine projects.
- Participate as needed in the planning and operation of YHN presentations at conferences and exhibits.
- Perform other duties as requested.
- Strong experience in managedhealthcarecontracting, negotiations, hearing care industry, market trends and areas related to provider reimbursement and current payer environment.
- Understanding of Medicare and Medicaid coverage as it relates to Hearing Care and senior demographics
- Managed Care experience through operations or contracting.
- Excellent networking skills.
- Strong relationship development skills.
- Ability to work independently, to be innovative and assume responsibility for projects and tasks
- Ability to interact effectively with all levels of management and staff.
- Creative in use of resources and providing problem resolution.
- Strong service focus and customer service skills.
- Ability to meet and exceed the needs of the customer at all times.
- Strong written and oral communication skills; strong listening skills. Strong writing skills. An excellent communicator.
- Regulatory knowledge related to Managed care and Hearing Care industries
- Diplomatic yet assertive.
- Detail oriented.
- Effective time management skills.
- Professional demeanor.
- Proficiency with Microsoft office suite basic webpage operation, and CRM. Ability to build report concepts to meet organizational needs.
- Team builder committed to achieving common goals and objectives.
- Willingness to travel-minimum 50%
EDUCATION/EXPERIENCE: Bachelordegree or minimum 4years successful college level education. Experience in Hearing Health Care and the Hearing Aid industry is beneficial. 7 – 10years sales and management experiencerequired. Managed Care experience is helpful.