Director, Health Plan Success

🕒 il y a 18 jours

🇺🇸 États-Unis – Télétravail

💵 $120 000 - $150 000 / an

⏰ Temps Plein

🔴 Expert

👔 Directeur

👻 Score fantôme 2%

Ce que ça veut dire : la probabilité que personne ne recrute vraiment pour cette offre.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Flourish Health

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11 - 50 employés

🏥 Santé

🧘 Bien-être

🌍 Impact social

💰 Seed en 2022-02

Healthcare • Wellness • Social Impact

Flourish Health est une organisation de soins de santé mentale orientée par une mission, axée sur l'intervention précoce et le rétablissement durable des adolescents et des jeunes adultes souffrant de maladies mentales graves. L'entreprise fournit des services cliniques, des guides de soins, ainsi que des rôles de thérapie et de soutien à distance/hybrides visant à améliorer l'accès à un traitement fondé sur des preuves et à des soins centrés sur la famille. Flourish met l'accent sur la prévention des souffrances à long terme en élargissant l'accès à des soins de santé mentale efficaces et en soutenant les familles à travers une prise en charge et des conseils coordonnés.

Description

• 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

🎯 Exigences

• 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

🏖️ Avantages

• 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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