Sr. Provider Network Account Executive
Mass General Brigham Health Plan

Job Info

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.

We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.

Reporting to the Director, Provider Relations, the Senior Provider Relations Account Executive is responsible for managing the relationships of large territory of complex provider organizations and key constituents. They are responsible for the relationship management, provider education and engagement, and informing the organization of the provider perspective.

Essential Functions
Relationship Building & Engagement
• Must be able to demonstrate relationship management, instill credibility and trust, and influence through collaboration.
• Create effective communications; identifying appropriate message content, deliver clear verbal and written communications.
• Execute and support the development of engagement strategies within territory.
• Maintain effective working relationships with provider community within identified region.
• Understand and communicate community-related issues affecting provider-Mass General Brigham Health Plan relationships.
• Work collaboratively with the Provider Education & Training Manager to develop educational materials and resources to support territory.
• When required, present educational and training materials to large provider audiences (100+).
• Proactively engage providers identifying; educational opportunities that decrease administrative burden, ensure provider compliance to contract terms, and enhance performance.
• Understand relationships and referral patterns within territory, contract terms, and reimbursement methodologies.
• When necessary, attend and represent Mass General Brigham Health Plan at provider network events and functions.

Provider Management & Complex Problem Solving
• Work directly with Contract Managers to support the overall contract management and maintenance as it relates to relationship management.
• Ability to analyze reports and data and make recommendations or decisions to add value.
• Maintain operations management practices with large health care delivery systems, key constituents, and providers under complex contractual agreements.
• Apply appropriate timeframes in response to provider inquiries and escalations.
• Ability to develop provider specific project plans to aid in resolution of complex provider issues.
• Ability to lead and facilitate meetings with cross-collaborative work groups consisting of internal and external constituents.
• Display preparedness and command of meeting topics and agenda items and ensure appropriate stakeholders are heard and involved in decision making conversations.
• Hold self and others accountable with use of target dates and meeting organizational tools i.e. agendas, minutes, task lists, project grids etc.
• Support roster management and ensure proper distribution to Provider Enrollment

Interdepartmental & Company Support
• When needed, provide consultative support to various initiatives and workgroups by sharing provider perspective.
• When necessary, represent Provider Relations on internal workgroups and initiatives.
• Conduct independent research on provider issues and bring to timely resolution.
• Escalate complex problems with suggested root cause and potential solution.
• Foster an atmosphere of collaborative teamwork and diversity within the department, division and the company.
• Act as conduit of competitor and market information affecting local providers and share with leadership.
• Collaborate with other departments and teams to create administrative simplifications.
• Support company recruitment activities.
• Provide overall management of the entity relationship and maintains support model with entity senior personnel
• Strong ability to analyze and resolve complicated problems with downstream impacts.
• Must understand local provider health care issues and trends.
• Must have proven ability to establish and maintain durable and professional relationships with providers and other constituents.
• Possess strong verbal, written and presentation skills.
• Must have ability to use sound judgment when faced with ambiguous situations.
• Must be flexible to balance and prioritize workloads, persistent in accomplishing goals and be self-motivated.
• Must be process and improvement oriented; accept new ideas as opportunities.
• Consistently embrace change, model a positive outlook, and foster team work and collaboration.

General
• Hold self and others accountable to meet commitments.
• Ensure diversity, equity, and inclusion are integrated as a guiding principle.
• Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
• Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
• Other duties as assigned with or without accommodation.

Working Conditions and Physical Effort
• Must be willing to travel to provider offices located across New England
• Must have valid license and method of transportation.
• Work is normally performed in a typical office work environment, but may involve visits to hospitals and patient care settings.

Qualifications
Minimum Requirements
Knowledge and Education

Required:
• Bachelor's Degree or the equivalent combination of training and experience, plus 5 years of related experience.

Experience

Required:
• 5 years of relevant experience.

Skills/Competencies

• Demonstrate Mass General Brigham Health Plan's core brand principles of always listening, challenging conventions, and providing value.
• Strong aptitude for technology-based solutions.
• Ability to inject energy, when and where it's needed.
• Respect the talent and unique contribution of every individual, and treat all people in a fair and equitable manner.
• Exercise self-awareness; monitor impact on others; be receptive to and seek out feedback; use self-discipline to adjust to feedback.
• Be accountable for delivering high-quality work. Act with a clear sense of ownership.
• Bring fresh ideas forward by actively listening to and working with employees and the people we serve.

Action

• Independently engage with provider community.
• Identify situations of risk and negative impact to organization and provider and escalate accordingly.
• Assess or request analytics to support financial analysis of complex issues
• Decide how to resolve complex issues and what resources are needed.
• Independently engage with other resources within organization.
• Generate conversations with providers on topics that impact our mutual business.
• Identify when project planning resources are needed to manage a complex problem.

This position internally interacts with all levels of the organization from front line to Executive Leadership. Most frequently interacting with Directors, Managers, and Supervisors. Externally, this role interacts with various levels of provider/hospital administrative staff such as Directors of Managed Care, CFO's, Billing Administrators and Office Managers.

EEO Statement
Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.