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Form of workSalary Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.)
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
Job Summary
The Delegation Oversight Account Manager II will serve as the single point of contact between L.A. Care and its contracted entities as it relates to delegate performance. The Account & Communications Manager II will be assigned up to four delegate accounts and will be responsible for facilitating the collection of performance related data, follow up on outstanding data, facilitating annual audit processes, triaging notices of non-compliance, and executing the internal and delegate communications strategy. Assigned accounts include large provider organizations (i.e. PPGs, Specialty Health Plans, etc.) or partnering health plans. The Account & Communications Manager II is responsible maintaining the relationship between L.A. Care and its delegates in relation to performance and will streamline all communications from business units to delegates. It will maintain a repository of communications to ensure consistency and will triage delegate communications is it relates to performance metrics and standards. The Account & Communications Manager II will regularly meet and coordinate with internal business units to ensure accuracy in communications and warm transfer of information.
Duties
Executes a single point of contact communication and account management strategy for all delegates as it relates to performance. Serves as a communication link between assigned accounts and LAC.
Completes regularly scheduled meetings (site visits, or conference calls) with all accounts. Translate information exchange, ideas, requests and other inquiries into actionable items for improved relationship management and enhanced performance.
Responsible for the project management and facilitation and collection of monitoring, reporting, and audit activities and will liaise with business units and auditors in the coordination of each activity.
Serves as the conduit through which all communications flow between business units and their counterparts at delegated entities. Conduct internal monthly meetings with stakeholders reviewing delegate performance.
Implements communication protocols to ensure all delegates are consistently and uniformly informed of L.A. Care's expectations and their performance. DeliverS accurate, timely, and appropriate information to their assigned accounts and maintain a repository of all communications.
Communicates to delegates will include but not be limited to: 1. Data submissions, 2. Monitoring results, 3. Audit Results, 4. Remediation Efforts, 5. CAP Statuses, 6. Sanctions decisions, 7. Delegate responses and updates.
Drafts and sends monthly delegate newsletters for performance information impacting all delegates and celebrating high performing delegates.
Maintains an understanding of LACs reports and metrics to evaluate the performance of assigned providers and/or provider organizations, and uses the data to develop and implement methods to improve relationships with all providers. Assists in all corrective actions required, up to and including termination, following LAC policies and procedures, and applicable contractual and regulatory requirements.
Performs other duties as assigned.
Duties Continued
Education Required
Bachelor's Degree
In lieu of degree, equivalent education and/or experience may be considered.
Education Preferred
Master's Degree
Experience
Required:
At least 3-5 years of experience in provider relations, account management, or relationship management in managed care or healthcare industry.
At least 3 years of healthcare experience in Managed Care; or, with a physician group, clinical-based organization, and/or in a hospital/facility setting.
Proven ability to work with a diverse group of people, including physicians, support staff, coworkers and management.
Demonstrated ability to research issues and bring about resolution either directly or with the assistance of others.
Skills
Required:
Good organizational skills and demonstrate excellent attention to detail and follow up skills.
Competent computer skills; MS Office skills required.
Excellent customer service skills with the ability to make independent judgments, handle multiple projects simultaneously, adapt to shifting priorities and utilize time management skills to meet deadlines.
Must have excellent written and verbal communications skills and the ability to communicate effectively with management and non-management personnel, and LAC provider network physicians.
Possess a professional and mature demeanor at all times.
Ability to work in a fast-paced department independently and handle multiple tasks; work with interruptions and deal effectively with confidential information.
Licenses/Certifications Required
Active & Current Driver's License, with a clean record and Auto Insurance Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
Light
Additional Information
Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
L.A. Care offers a wide range of benefits including
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
Job Summary
The Delegation Oversight Account Manager II will serve as the single point of contact between L.A. Care and its contracted entities as it relates to delegate performance. The Account & Communications Manager II will be assigned up to four delegate accounts and will be responsible for facilitating the collection of performance related data, follow up on outstanding data, facilitating annual audit processes, triaging notices of non-compliance, and executing the internal and delegate communications strategy. Assigned accounts include large provider organizations (i.e. PPGs, Specialty Health Plans, etc.) or partnering health plans. The Account & Communications Manager II is responsible maintaining the relationship between L.A. Care and its delegates in relation to performance and will streamline all communications from business units to delegates. It will maintain a repository of communications to ensure consistency and will triage delegate communications is it relates to performance metrics and standards. The Account & Communications Manager II will regularly meet and coordinate with internal business units to ensure accuracy in communications and warm transfer of information.
Duties
Executes a single point of contact communication and account management strategy for all delegates as it relates to performance. Serves as a communication link between assigned accounts and LAC.
Completes regularly scheduled meetings (site visits, or conference calls) with all accounts. Translate information exchange, ideas, requests and other inquiries into actionable items for improved relationship management and enhanced performance.
Responsible for the project management and facilitation and collection of monitoring, reporting, and audit activities and will liaise with business units and auditors in the coordination of each activity.
Serves as the conduit through which all communications flow between business units and their counterparts at delegated entities. Conduct internal monthly meetings with stakeholders reviewing delegate performance.
Implements communication protocols to ensure all delegates are consistently and uniformly informed of L.A. Care's expectations and their performance. DeliverS accurate, timely, and appropriate information to their assigned accounts and maintain a repository of all communications.
Communicates to delegates will include but not be limited to: 1. Data submissions, 2. Monitoring results, 3. Audit Results, 4. Remediation Efforts, 5. CAP Statuses, 6. Sanctions decisions, 7. Delegate responses and updates.
Drafts and sends monthly delegate newsletters for performance information impacting all delegates and celebrating high performing delegates.
Maintains an understanding of LACs reports and metrics to evaluate the performance of assigned providers and/or provider organizations, and uses the data to develop and implement methods to improve relationships with all providers. Assists in all corrective actions required, up to and including termination, following LAC policies and procedures, and applicable contractual and regulatory requirements.
Performs other duties as assigned.
Duties Continued
Education Required
Bachelor's Degree
In lieu of degree, equivalent education and/or experience may be considered.
Education Preferred
Master's Degree
Experience
Required:
At least 3-5 years of experience in provider relations, account management, or relationship management in managed care or healthcare industry.
At least 3 years of healthcare experience in Managed Care; or, with a physician group, clinical-based organization, and/or in a hospital/facility setting.
Proven ability to work with a diverse group of people, including physicians, support staff, coworkers and management.
Demonstrated ability to research issues and bring about resolution either directly or with the assistance of others.
Skills
Required:
Good organizational skills and demonstrate excellent attention to detail and follow up skills.
Competent computer skills; MS Office skills required.
Excellent customer service skills with the ability to make independent judgments, handle multiple projects simultaneously, adapt to shifting priorities and utilize time management skills to meet deadlines.
Must have excellent written and verbal communications skills and the ability to communicate effectively with management and non-management personnel, and LAC provider network physicians.
Possess a professional and mature demeanor at all times.
Ability to work in a fast-paced department independently and handle multiple tasks; work with interruptions and deal effectively with confidential information.
Licenses/Certifications Required
Active & Current Driver's License, with a clean record and Auto Insurance Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
Light
Additional Information
Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
L.A. Care offers a wide range of benefits including
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)
