Senior Territory Account Manager - Healthcare
IlluminaFull Time
Senior (5 to 8 years)
Candidates must possess an Associate's degree in nursing or a business health field, coupled with over 3 years of prior professional experience and progressive operational leadership experience over a large clinical metric-intensive operational unit. Certification in Six Sigma, Lean, or Project Management is required, along with proficiency in Microsoft Office applications (Word, Excel, PowerPoint), strong verbal and written communication skills, strong facilitation skills, and management experience including the evaluation of clinical metrics. The role also requires a Monday-Friday schedule from 8 AM to 5:30 PM EST and the ability to work with little to no direction, exercising considerable latitude in determining objectives and approaches to assignments. A clinical background is necessary for overseeing clinical work, reviewing audit data, and collaborating on process and educational opportunities. Preferred qualifications include a Bachelor's degree, prior experience in a healthcare or insurance setting, knowledge of Medicare Advantage, experience with Grievance and Appeals, virtual environment work, previous vendor management experience, auto-dialer or call center work, and previous SNP experience.
The Senior Vendor Management Professional will review and negotiate vendor contract terms, manage day-to-day vendor communications, and build/maintain positive vendor relationships while monitoring vendor performance. Responsibilities include researching and resolving invoice and contractual issues, influencing vendor strategy, and making decisions on technical approaches for project components. The role involves monitoring, researching, and resolving contractual, performance, and invoice issues/errors, collaborating to identify vendor opportunities and strategy, and facilitating meetings with varying levels of leadership and project resources. Additionally, the position entails managing vendor back-office inventory, including volume forecasting, staffing based on forecasting, reporting, and process management. Regular communication with business and vendor partners regarding daily operations, clinical quality, and project responsibilities is essential. The role also includes managing mid- to large-size projects through their entire lifecycle, gathering project and service requirements, developing project plans and schedules, measuring progress against plans, and setting priorities to manage team implementation and post-production validation.
Health insurance provider for seniors and military
Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.