Utilization Management (UM) Account Manager (Remote U.S.)

Company Description

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company, to actively engage in problem-solving, and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Job Description

Acentra seeks a Utilization Management Account Manager to join our growing team.

Job Summary:

The Utilization Management Account Manager will:

Build strong relationships with customers’ senior management and account management staff.
Develop a business partnership that promotes opportunities for growth and revenue while supporting the customer’s growth objectives.
Optimize service to customers by identifying their needs and providing solutions within the scope of contracted services.
Provide high-level internal communications within Acentra Health regarding clients and their vendor partners.

Job Responsibilities:

Develop and strengthen relationships at the account management and senior management levels of key clients. Identify current and future service requirements by establishing personal rapport with key individuals who understand service requirements.
Serve as a subject matter expert to customers by providing high-level product and service information. Demonstrate the impact of Acentra Health’s services for cost reductions and operations improvements. Manage contract and scope of work to ensure proper services are provided and avoid non-reimbursed services. Up-sell more services to existing traditional customers as well as to re-sell customers and partners.
Establish and regularly update a strategic plan for each assigned account. Components of the plan include a schedule of deliverables with time frames, identified goals, customer relationship enhancements, and revenue growth.
Provide training to the client for online reports and is the first contact for troubleshooting login issues related to the reports.
Facilitate client communication and follow-ups to resolve outstanding issues and questions, and connects Operations, Finance, and Clinical areas to support client management.
Communicate with staff regarding changes to services assigned to the contract.
Serve as the main point of contact for clients related to policy changes, report requests, system changes and requests, etc.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

Qualifications

Required Qualifications/Experience:

Active, unrestricted Registered Nurse (RN) license or a compact state license.
Bachelor’s Degree or equivalent directly applicable experience in nursing, healthcare administration, or related area.
Previous project or account management experience with a health plan.

Preferred Qualifications/Experience:

3+ years of utilization review experience.
Previous experience managing account relations or serving as a liaison to customers.

Knowledge, Skills, Abilities:

Excellent verbal and written communication skills.
Current working knowledge of utilization management, case management, and managed care.
Customer-focused, results-oriented, and capable of building and maintaining relationships with internal and external customers.
Organizational skills, ability to plan and prioritize multiple assignments.
Current InterQual and Milliman criteria knowledge.
Skill in examining and re-examining operations and procedures, formulating policy, and developing and implementing new strategies and procedures.
Knowledge of the U.S. healthcare industry.
Experience in using systems that support Utilization and Case Management processing.
Demonstrated expertise in managing differing customer needs.
Understanding of Utilization Review Accreditation Committee (URAC) standards and processes.
Ability to participate as a team member, fostering collaborative decision-making among leadership, committees, teams, or work groups of diverse composition.
Computer proficiency in Microsoft Office applications and other software programs essential to perform job functions.
Ability to develop, plan, and implement short-and long-range goals.
Skills in employee development and performance management.
Ability to provide technical guidance and leadership to the management team.
Advanced verbal and written communication skills and the ability to work with a wide range of constituencies in a diverse community.

Compensation

The pay range for this position is $95,000-105,000 / year.

“Based on our compensation philosophy, an applicant’s placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”

Please apply directly on our Careers site using the following link: https://apply.workable.com/kepro/j/7312BBEA7D/

Additional Information

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people’s lives nationwide. Our company cares about our employees, giving you the tools and encouragement you need to achieve the finest work of your career.

Benefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Thank You!

We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

Originally posted on Himalayas

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