Account Manager, ACOs, Medicare Supplement

🕒 Maio 15

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $100.000 - $110.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

💰 Gerente de Contas

🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of Ceresti Health

Ceresti Health

11 - 50 funcionários

Fundada em 2013

🏥 Saúde

⚕️ Seguro de Saúde

🤝 B2B

💰 $11.726.799 Venture Round - Ceresti Health em 2025-08

Healthcare • Healthcare Insurance • B2B

A Ceresti Health é uma empresa de assistência habilitada por tecnologia que faz parceria com planos de saúde e organizações de cuidados responsáveis (ACOs) para apoiar cuidadores familiares de pessoas com demência. A empresa combina a estratificação de risco orientada por dados de sinistros, educação para cuidadores, uma plataforma baseada em tablet e navegadores de cuidados pessoais semanais para melhorar a adesão ao plano de cuidados, fechar lacunas nos determinantes sociais de saúde e detectar proativamente mudanças nas condições dos pacientes. O programa liderado por cuidadores da Ceresti possui resultados validados de forma independente que mostram reduções substanciais em hospitalizações evitáveis e nos custos médicos por paciente, oferecendo contratos baseados em resultados sem risco para pagadores.

Descrição

• Serve as the primary account owner for assigned ACO and MediGap carrier partners from post-implementation through steady state • Build trusted relationships with ACO leadership, operations teams, clinical leaders, care management staff, and MediGap carrier product, compliance, and member services teams • Understand and communicate GUIDE Model workflows to ACO care teams • Help MediGap carriers operationalize Ceresti’s program for their member populations • Act as Ceresti’s internal liaison for each partner and address partner needs, constraints, and priorities • Support contract adherence, shared savings alignment, GUIDE Model performance targets, and partnership health • Own enrollment performance, including referral flow, member outreach, program utilization, outreach effectiveness, and caregiver activation • Improve uptake through provider education, workflow refinement, targeted engagement, carrier marketing integration, and member communications • Drive physician awareness and buy-in across assigned ACO networks • Enable carrier member services teams to support GUIDE Model enrollment and workflows • Coordinate patient-, provider-, and carrier-facing materials, training, and communications • Build trust and governance alignment for proactive outreach to eligible beneficiaries • Own approvals, workflows, and communication protocols for proactive enrollment • Coordinate with Implementation, GUIDE Coordinators, Coaching, and Operations teams • Support CCLF data file refreshes, carrier eligibility file exchanges, data-sharing workflows, and outreach approvals • Monitor operational SLAs, outreach cadence, member experience, compliance, enrollment, engagement, outcomes, and operational performance • Lead recurring partner check-ins and business reviews • Deliver data-driven updates and executive-ready insights to ACO and MediGap carrier stakeholders

🎯 Requisitos

• Bachelor’s degree in a related field • 5+ years of experience in account management, client success, provider relations, carrier/payer relations, or partnership management within healthcare • Experience working with ACOs, Medicare Advantage plans, Medicare Supplement (MediGap) carriers, or value-based care organizations • Direct experience with MediGap carriers, CMS care model delivery, or carrier product and operations teams is strongly valued • Strong understanding of healthcare operations, provider workflows, and population health models • Proven ability to manage complex, multi-stakeholder relationships • Exceptional communication, organization, and follow-through skills • Exceptional problem-solving skills • Experience supporting CMS models such as GUIDE, MSSP, or ACO REACH • Familiarity with caregiver support, dementia care, home care, or care management models • Experience managing carrier or health plan accounts, including CMS model implementation, member engagement, or GUIDE-adjacent program delivery • Experience presenting performance data and outcomes to executive audiences • Comfort working in a high-growth, fast-moving startup environment • Experience with HubSpot is a plus

🏖️ Benefícios

• Full benefits • Remote-first environment • Competitive compensation

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