Health Plan Account Dir Sr – Remote

Job title: Health Plan Account Dir Sr – Remote

Company: Prime Therapeutics

Job description: Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.Job Posting TitleHealth Plan Account Dir Sr – RemoteJob DescriptionThe Sr Health Plan Account Director leads the development and execution of strategic plans for health plans or select services and Direct to Employer (DTE) groups and will be assigned as the LOB expert across one or more health plans. This position establishes and maintains relationships with client decision-makers, industry consultants, health-plan account and sales divisions, and Prime’s functional areas to enhance collaboration, and ensure delivery of exceptional service. As necessary, this position will oversee a cross-functional account management team, with representation across all lines of business, and key departments such as clinical, trade, and finance to ensure strategic alignment and execution.Responsibilities

• Serve as relationship and contract owner, advocate and point of escalation for assigned account/s; leverage an intimate understanding of the industry, client market trends, challenges, and priorities, and the demand for new products/services in the market, as well as Prime’s strategic and growth objectives to lead the development and deployment of client strategic plans; collaborate with Prime and Client leadership to advocate for products and capabilities that support mutual growth and enable market competitive solutions; solicit client feedback related to products, financials and contracts and establish an internal framework to respond to suggestions or inquiries
• Lead retention efforts for clients spanning one or more line of business (Employer Markets, Health Insurance Marketplace, Commercial, Medicare, Medicaid, Specialty) or with unique Prime contract requirements; drive the adoption and consistent application of client communication and interaction principles developed by the Account Management Office; lead efforts to ensure a coordinated client experience by creating awareness, accountability, and alignment to these principles across client engagement and Prime
• Lead client meetings as aligned to the account management principles, including but not limited to: identifying meeting objectives and participants, ensuring adequate preparation and presentation materials, disseminating and uploading meeting materials in client portal, and working across extended teams to ensure appropriate follow through and documentation; document interactions with assigned client/s and input into the Salesforce CRM tool and client portal, including but not limited to meeting agendas and notes, identified dependencies or risks, key decision points and outcomes, and any next steps, agreed actions and responsibly parties
• Monitor and report on key performance indicators and dashboards that evaluate Prime’s performance against assigned client contracts; populate joint scorecards and other reporting tools (i.e. Salesforce) to track client relationships, product adoption and retention metrics, and proactively respond to, and remediate any identified gaps or risks; understand nuances across lines of business or assigned client/s and identify further opportunity to drive consistency and improvement
• Lead the development, negotiation and compliance of client contracts; proactively analyze contract language and/or requirements and collaborate with internal stakeholders to implement a renewal action plan, standardize contract language where appropriate, and mitigate conflicting terms; review and manage Performance Guarantees and/or Financial Guarantees on behalf of Prime and the client(s) to minimize financial risk
• Partner with employer market sales and account management teams on go-to-market pull through
• Provide cross functional leadership to an extended Account Management team, with representation, expertise and dedicated support for market/line of business-specific client needs; collaborate with cross-functional leaders to identify and implement collaborative, performance objectives across all client facing teams; ensure clear lines of accountability and expectations between client engagement and extended client team members; lead efforts to align interactions with strategic and operational objectives that identify, develop, expand and retain key client relationships
• Identify key relationships necessary to deliver core and expanded capabilities, drive growth, and ensure market competitiveness, including but not limited to: executive sponsors, Blue Cross Blue Shield (BCBS) plans, national benefits consultants, ensure account management team maintains effective LOB (Line of Business) knowledge and expertise via industry channels, conferences, continuing education etc; demonstrate thorough understanding and commitment to compliance requirements and influence the alignment, prioritization, design and implementation of outcomes and services
• May manage staffing, performance and development of a small client engagement team; will consistently demonstrate Prime’s leadership and employee expectations during interactions with direct reports (if applicable), cross functional and external stakeholders; directly or indirectly establish account management goals and priorities for the extended client teams
• Other duties as assigned

Minimum Qualifications

• Bachelor’s degree in Finance, Business, Health Care Administration, or related area of study or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
• 10 years of client service experience in healthcare or insurance, to include 6 years of account management in PBM or managed care
• Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

• Expert interpersonal skills, with the ability to effectively facilitate meetings, resolve conflict, build consensus, establish rapport and collaborate effectively across departments, internally and externally, and at all levels within an organization; proven ability to “manage up” and maintain appropriate executive presence when communicating client standing, issues, and strategies
• Demonstrated ability to drive the identification of improvement opportunities and leading the implementation of process changes
• Exceptional communication and relationship management skills with ability to communicate complex information to a variety of audiences, influence strategic outcomes, and maintain executive and senior leader relationships with clients and consultants
• Strong analytical and critical thinking skills; able to synthesize information from multiple sources into actionable plans
• Able to balance and prioritize compliance, business and other competing goals and risks, while still driving programs and initiatives to completion
• Strong financial and industry acumen

Preferred Qualifications

• MBA or other related advanced degree
• Experience working within assigned line of business or market segment (Commercial, Medicare, Medicaid, Health Insurance Marketplace, and/or Employer Markets) or with assigned health plan clients
• Leadership/people management experience

Minimum Physical Job Requirements

• Ability to travel up to 50% of the time
• Constantly required to sit, use hands to handle or feel, talk and hear
• Frequently required to reach with hands and arms
• Occasionally required to stand, walk and stoop, kneel, and crouch
• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Reporting Structure

• Reports to an Assistant Vice President Account Management or the Vice President Client Success in the commercial and government markets department

Potential pay for this position ranges from $125,200.00 – $200,000.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.To review our Benefits, Incentives and Additional Compensation, visit our and click on the “Benefits at a glance” button for more detail.Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.Prime Therapeutics LLC is a Tobacco-Free Workplace employer.Positions will be posted for a minimum of five consecutive workdays.

Expected salary: $125200 – 200000 per year

Location: USA

Job date: Fri, 25 Oct 2024 22:42:37 GMT

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