About the Organization:

Equality Health is an integrated, holistic, and tech-enabled healthcare delivery system focused on improving the health and wellness of diverse populations. Founded in 2015, Equality Health aims to improve access to value-based care for people who have long struggled with navigating the traditional one-size-fits-all U.S. healthcare system. The mission of the company is to provide high-quality care that improves and enhances lives regardless of race, ethnicity, age, or income.

Through its supplemental care management services and proprietary technology platform, CareEmpower™, Equality Health helps managed care plans and health systems improve outcomes and lower costs for diverse populations while simultaneously facilitating the transition to risk-based accountability. Equality Health supports over 800,000 members and more than 4,000 practice sites and continues to scale rapidly.

In 2021, Equality Health partnered with General Atlantic, a leading global growth equity firm, to help drive continued expansion and fuel the next phase of growth as a leading value-based primary care network serving the Medicaid, Medicare and ACA Exchange populations. This strategic investment will enable Equality Health to pursue further geographic expansion, technological innovation and product development while furthering its mission of increasing access to care, lowering costs and improving outcomes for underserved individuals, families and communities.

About the Role:

The Strategic Account Manager is responsible for development of a regional territory inclusive of provider selection and satisfaction as well as member growth and medical loss ratio. This position resolves managed-care issues and/or problems related to claims, medical management, or member services issues, as well as identifies educational needs within the provider network and initiates educational efforts as needed or upon provider’s request. A key part of this role is conducting territory assessment and developing strategic plans for service areas, while delivering exceptional service to participating providers in the assigned geographic region. This individual must be located in Arizona or Texas. Note: There is a 10-15% required travel component for this role.

Key Responsibilities:

• Develop and maintain short-term and long-term business plans for account performance, growth and retention
• Identify and build strategies to include Equality Health solutions to support client initiatives
• Establish clear internal and external communication channels pertaining to accounts
• Communicate with clients on a regular basis and respond to specific queries
• Identify and coordinate internal teams to deliver on contractual commitments
• Work collaboratively with the Practice Performance function to ensure an aligned provider account management approach and close coordination to effectively execute the new group/practice training and onboarding process
• Collaborate with Shared Services functional areas to ensure appropriate support for designated accounts
• Serve as the key subject matter expert (SME) on local provider dynamics
• Provide comprehensive reports on client growth and strategy
• Manage escalation process and provide options for resolution
• Work with internal Community and Marketing teams to promote and coordinate community outreach efforts with Client partners (e.g., partnership promotions and joint events)
• Develop and conduct designated business review presentations and special events with existing clients both in-person and virtually
• Play an integral role in developing and maintaining the EQH’s mission and vision within the community and healthcare landscape
• Plan, coordinate, and effectively lead project management activities

Required Skills & Qualifications:

• Ability to accomodate 10-15% travel for role's responsibilities
• Undergraduate degree from an accredited college in Business, Science or related health field, or equivalent experience in customer service, healthcare administration, healthcare management, or other closely related field
• 2+ years of customer relations experience working directly with healthcare practitioners in a medical or pharmaceutical environment and direct experience in a healthcare network development role or related position
• 1+ years of experience with sales initiatives, provider research and market analysis
• Demonstrated understanding of risk and value-based contracting
• Demonstrated provider relations skills
• Proficiency with Microsoft Office applications
• Strong interpersonal and communication skills, with experience managing external relationships
• Ability to plan and execute engagement activities and manage multiple priorities
• Proficiency in maintaining accurate records and using engagement tools or platforms

Preferred Skills & Qualifications:

• 5+ years of experience in outreach, provider relations, or healthcare operations and/or managed care (Provider Relations/Services; Claims Adjudication, Medical Coding, Contracting)
• Working knowledge of the designated QNXT referral, claims, eligibility, and provider modules, as well as all CACTUS modules, and serves as the primary party responsible for responding to inquiries referred to Provider Relations
• Familiar with payment alternatives such as fee for service, capitation, global budget, performance compensation and episode of care payment
• Familiar with patient and practice risk adjustment mechanics and premium-based payment methodologies? ?
• Familiar with patient and practice risk adjustment mechanics, APR; HCC/RAF?
• Familiar with conventional payment methodologies (CMS-RBRVS)
• Experience creating and delivering presentations and reports
• Experience with data analytics and Tableau
• Experience supporting referral workflows or provider engagement in a healthcare setting; familiarity with healthcare regulations and compliance standards
• Knowledge of CRM platforms or communication tools for managing provider relationships

Disclaimer: This job description may not be inclusive of all assigned duties and responsibilities, or aspects of the job described, and may be amended at any time at the sole discretion of the employer

Equality Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status.