This is a hybrid role that requires regular travel to provider sites and occasional onsite team meetings.
The Ancillary Provider Relations Account Executive - One Care & Senior Care Options (SCO) is responsible for relationship management, education and engagement for ancillary providers, including Community Based Organizations (CBOs), within the One Care & SCO service area. CBOs, and other ancillary providers, deliver long-term services and supports to enable members of Mass General Brigham Health Plan's Dual Eligible Special Needs Plans to live independently and safely in their preferred community setting. This role will successfully execute on department and corporate strategies and initiatives.
Relationship Building & Engagement
With appropriate support, serve as the lead relationship manager, educator and engagement coordinator for CBOs and other ancillary providers.
Create effective communication strategies, conveying clear messages, identifying appropriate message content & delivery, listening actively, and developing clear written communications with assistance from manager, as necessary.
Support the development and execution of education and engagement strategies within the One Care / SCO service area.
Maintain effective working relationships with CBOs and other ancillary providers in the One Care / SCO networks.
Operate as a subject matter expert for long-term support services covered under the Dual Eligible Special Needs Plans and communicate relevant information related to the plan to providers.
Apply in-depth knowledge to align Mass General Brigham Health Plan's organizational goals with the needs of CBOs and other ancillary providers, ensuring mutual success through clear communication, tailored solutions, and strategic support in provider relations.
Maintain working knowledge of the Model of Care for the Dual Eligible Special Needs Plans to ensure provider relations engagement aligns with organizational strategies.
Identify, socialize potential educational resources, appropriate training materials with leadership.
Ability to present educational and training materials to CBOs.
Proactively engage One Care and SCO ancillary provider leadership to understand expectations and assist with challenges.
Routinely meet with and communicate business changes to key stakeholders to ensure smooth payer/provider interactions.
When necessary, attend and represent Mass General Brigham Health Plan at provider network events and functions.
Ability to understand how to use and educate One Care and SCO ancillary providers on website navigation.
Ability to serve members and providers with an enhanced focus on cultural competency to understand the individual needs of all stakeholders.
Communicate with confidence difficult messages that support company decisions while maintaining credibility with providers.
Monitor and analyze the duals landscape and recommend programs and policies to proactively address the changing needs of members / ancillary provider organizations.
Complex Problem Solving & Provider Management
Ability to analyze reports.
Ability to understand and solve complex problems and seek out direction from manager when appropriate.
Identify, research, and track timeliness of resolution of complex provider issues.
Maintain organization tools to track deliverables to key stakeholders.
Apply appropriate timeframes in response to provider inquiries and escalations.
Ability to facilitate meetings with cross-collaborative work groups consisting of internal and external stakeholders.
Display preparedness and command of meeting topics and agenda items and work with manager to ensure appropriate attendees are represented.
Hold self and others accountable with use of target dates and meeting organizational tools (i.e. agendas, minutes, task lists, project grids, etc.)
Interdepartmental & Company Support
Represent Provider Relations on internal workgroups and initiatives, when necessary
Develop and execute collaboration initiatives to minimize provider abrasion.
Conduct independent research on One Care and SCO ancillary provider issues and bring them to timely resolution.
Escalate complex problems with suggested root causes and potential solutions where possible.
Foster an atmosphere of collaborative teamwork and diversity within the department, division, and the company.
Act as a conduit of provider and competitor intelligence and share with the manager.
Support cross-functional efforts in providing educational training to internal teams related to ancillary providers and their role in the One Care / SCO plans.
Collaborate with other departments and teams to create administrative simplifications.
Support company recruitment activities.
Independently engage with the ancillary provider community.
Identify situations of risk and negative impact to the organization and provider and escalate accordingly.
Assess or request analytics to support financial analysis of complex issues.
Decide how to resolve complex issues and what resources are needed.
Independently engage with other resources within the organization.
Generate conversations with providers on topics that impact our mutual business.
Hold self and others accountable to meet commitments.
Ensure diversity, equity, and inclusion are integrated as a guiding principle.
Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
Other duties as assigned with or without accommodation.
Qualifications
Bachelor's degree required or the equivalent combination of training and experience (master's degree, preferred).
At least 5 years of experience with management of provider relationships.
Experience with CBOs and/or providers of long-term support services, preferred.
Nuanced understanding of the Massachusetts CBO landscape, preferred.
Proven leadership, decision-making and consensus and relationship building skills.
About Us:
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.
We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.
EEO Statement
Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided with reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
