Director, Health Plan Success

🕒 Outubro 19

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $120.000 - $150.000 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

👻 Score fantasma 2%

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Flourish Health

SiteLinkedInTodas as Vagas

11 - 50 funcionários

🏥 Saúde

🧘 Bem-estar

🌍 Impacto Social

💰 Seed em 2022-02

Healthcare • Wellness • Social Impact

A Flourish Health é uma organização de saúde mental voltada para a missão, com foco em intervenção precoce e recuperação sustentada para adolescentes e jovens adultos com doenças mentais graves. A empresa oferece serviços clínicos, guias de cuidados e funções de terapia e apoio remoto/híbrido, visando melhorar o acesso a tratamentos baseados em evidências e cuidados centrados na família. A Flourish enfatiza a prevenção do sofrimento a longo prazo, ampliando o acesso a cuidados eficazes de saúde mental e apoiando as famílias através do cuidado coordenado ao paciente e orientação.

Descrição

• Serve as the primary relationship owner for a portfolio of existing contracted health plans • Build and maintain trusted relationships with health plan executives, behavioral health leaders, clinical teams, network management, and operational stakeholders • Develop partner-specific understanding of strategic priorities, membership needs, operational challenges, and expectations • Establish communication cadences including regular check-ins, quarterly business reviews, and executive-level meetings • Identify and address relationship risks, partner concerns, and emerging opportunities • Own health plan partnership success, contractual commitments, partner experience, retention, and contract performance • Build power/preference charts and account success plans with objectives, metrics, stakeholder maps, and action items • Monitor referrals, admissions, patient engagement, clinical outcomes, utilization, and operational performance • Coordinate responses to health plan questions, escalations, and performance concerns • Prepare and present performance reports, joint operating committee meetings, and quarterly business reviews • Translate clinical outcomes, utilization trends, patient experience data, and financial impact into actionable insights • Demonstrate Flourish’s impact on hospitalizations, emergency department utilization, residential treatment, and other outcomes • Identify account growth opportunities including geographic expansion, additional populations, new products, and expanded contract scope • Support contract renewals, amendments, and expansions, partnering with the CEO on significant commercial negotiations • Coordinate cross-functional teams across Patient Growth, Payer Operations, Clinical Leadership, Finance, Product, Engineering, and other functions • Lead implementation and launch of new health plan contracts once execution likelihood reaches approximately 80% • Develop implementation plans and coordinate claims/billing readiness, case management engagement, and member-list/data integration workstreams • Establish implementation milestones, owners, timelines, and success criteria • Provide implementation updates to executive leadership and ensure seamless transition to ongoing account management • Develop repeatable implementation playbooks and processes

🎯 Requisitos

• 7+ years of experience in healthcare, including significant experience in health plan account management, payer partnerships, provider relations, client success, or a closely related function • Experience working directly with Medicaid managed care organizations or other health plan partners • Demonstrated success managing complex, high-value relationships with multiple stakeholders • Strong understanding of managed care operations, healthcare delivery, and payer-provider partnerships • Ability to interpret healthcare performance data, identify trends, and communicate actionable insights • Excellent executive communication, relationship management, and presentation skills • Strong project management skills, with the ability to coordinate complex initiatives across multiple teams • Demonstrated ability to navigate challenging partner conversations, resolve escalations, and build trust • High degree of ownership, initiative, organization, and attention to detail • Strong commitment to improving access, quality, and outcomes in behavioral healthcare • Preferred: Experience working with Medicaid behavioral health programs, specialty provider networks, or value-based care arrangements • Preferred: Experience managing relationships with national or regional Medicaid managed care organizations • Preferred: Familiarity with behavioral health utilization, clinical outcomes, and healthcare cost-of-care analyses • Preferred: Experience in a high-growth, technology-enabled healthcare services organization • Preferred: Experience supporting contract renewals, expansions, or strategic account growth • Preferred: Familiarity with CRM systems, account management platforms, and healthcare analytics tools • Must be eligible to work in the United States, as Flourish Health participates in E-Verify

🏖️ Benefícios

• 401(k) • Paid time off • Home office stipend • Health insurance • Vision insurance • Dental insurance • Remote work • Additional in-person event attendance 2+ times per year

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