Transforming the future of healthcare isn't something we take lightly. It takes teams of the best and the brightest, working together to make an impact.
As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities.
Here at Change Healthcare, we're using our influence to drive positive changes across the industry, and we want motivated and passionate people like you to help us continue to bring new and innovative ideas to life.
If you're ready to embrace your passion and do what you love with a company that's committed to supporting your future, then you belong at Change Healthcare.
Pursue purpose. Champion innovation. Earn trust. Be agile. Include all.
Empower Your Future. Make a Difference.
Sr. Account Manager, Payor Relations
The Senior Account Manager (Payment Integrity) is responsible for managing a block of business for new and existing customers in the commercial insurance/ payor market sector. In addition, this job is responsible for project management activities related to the identification and resolution of customer issues, process workflow enhancements and revenue performance increases.
The Senior Account Manager works under minimal supervision and with considerable discretion to accomplish job responsibilities. The incumbent collaborates with the department lead(s) and other management staff to ensure the most effective service delivery to clients. The Senior Account Manager applies a broad range of knowledge of principles, practices, and procedures of the field, works independently, and provides leadership to employees who do not directly report to the incumbent. The work is varied and complex, blending aspects of Payment Integrity focused business development / expansion, customer service, and implementation management. This position has the authority to recommend and implement appropriate policies, procedures, and controls to ensure compliance with applicable contractual provisions, regulations, and legislation.
- Manage client relationship from Senior Executives to day to day contacts for Payment Integrity services, including but not limited to coordination of projects:
- Resolution of issues to ensure client expectations are satisfied; provide feedback and status updates;
- Serve as liaison between client's operation management and organizational functional units. Coordinate, communicate and deliver client information to ensure successful implementation of new clients or modifications to existing accounts.
- Develop and maintain effective relationships and regular contact with key client stakeholders as well as executive and operational relationships to ensure secure and long-term business relationships.
- Develop and execute annual and quarterly account plan for the achievement of growth objectives for assigned clients.
- Collaborate with organizational leadership regarding sales effort related to business development and market expansion.
- Obtain client information and/or approvals for initiatives that improve the effectiveness or efficiency of services and maintain a working knowledge of the client's product, business culture and competition.
Education: Bachelor's degree in related field, or equivalent experience
- 5+ years of experience in the health care industry/payor relations experience (HMO, Group Health, Medicare, Medicaid, Commercial) with exposure to Payment Integrity
- 5+ years of experience in a client- facing account management role in healthcare technology/healthcare payor role.
- Knowledge of billing, coding, and payor reimbursement methods within health care
- Travel-Must be able to travel 25% (2 to 3 times) per months to clients.
- High proficiency in MS Office tools (Excel, Word, PowerPoint) for client presentations
- Project management skills, and strong planning and organizational skills.
- Project delivery methodology skills
- Exceptional facilitation skills and communicating strategies and adjusting strategies based on the feedback of stakeholders.
- Highly detailed oriented with the ability to troubleshoot issues/client requests quickly and provide organizational guidance.
- Ability to hold organization as well as clients accountable to deliver on operational requirements in order to deliver savings/revenue goals.
Desired Experience/Nice to Have:
- Advanced degree in health care or medical field
- Strong data, analytics, and quantitative acumen
- Familiarity with processes of CPT, HCPCS, ICD-9, revenue codes and DRG, coverage and reimbursement.
- Familiarity with health insurance claim forms, including UB-04, CMS-1500, explanation of benefits, and prior authorization forms, and superbills charge tickets to troubleshoot cases where billing, claims submission or documentation errors may occur
Additional Knowledge & Skills:
- Self-managed, self-starter with the ability to support multiple concurrent projects and meet tight delivery timelines
- Strong project management approach with excellent critical thinking and problem-solving skills
Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!
Equal Opportunity/Affirmative Action Commitment
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.