Director, Health Plan Success

🕒 vor 22 Tagen

🇺🇸 Vereinigte Staaten – Remote

💵 $120.000 - $150.000 / Jahr

⏰ Vollzeit

🔴 Experte

👔 Direktor

👻 Geisterscore 2%

Was es bedeutet: die Wahrscheinlichkeit, dass für diese Stelle niemand wirklich einstellt.So liest du es: 60 % oder höher heißt, wir halten das für einen Geisterjob. Niedrigere Werte sind weniger bedenklich.Warum dieser Wert:

• Seit 23 Tagen offen.
• Stellen bei diesem Unternehmen werden meist in 48 Tagen besetzt.

Jetzt Bewerben

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Flourish Health

WebsiteLinkedInAlle Stellen

11 - 50 Mitarbeiter

🏥 Gesundheitswesen

🧘 Wellness

🌍 Soziale Wirkung

💰 Seed im 2022-02

Healthcare • Wellness • Social Impact

Flourish Health ist eine mission-driven Organisation im Bereich der psychischen Gesundheit, die sich auf Frühintervention und nachhaltige Genesung für Jugendliche und junge Erwachsene mit schweren psychischen Erkrankungen konzentriert. Das Unternehmen bietet klinische Dienstleistungen, Betreuungsguides sowie Remote- und Hybridtherapie- und Unterstützungsrollen an, die darauf abzielen, den Zugang zu evidenzbasierter Behandlung und familienzentrierter Pflege zu verbessern. Flourish legt Wert darauf, langfristiges Leid zu verhindern, indem es den Zugang zu effektiver psychischer Gesundheitsversorgung erweitert und Familien durch koordinierte Patientenbetreuung und Anleitung unterstützt.

Beschreibung

• 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

🎯 Anforderungen

• 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

🏖️ Vorteile

• 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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