Emergent Holdings Director, BCBSM Medicare Key Accounts in Southfield, Michigan
The Senior Health Services Key Account position is charged with the responsibility of developing and maintaining client strategies on Medicare Advantage and as the point of contact for senior health services regarding MA business management for multiple key accounts. The role will be tasked with maintaining a long-term relationship for senior health services in the key account space and the development of additional senior health services large accounts. In sum, this role establishes strong consulting relationships and positions MA as a thought leader with the customer in coordination with the BCBSM Customer Units.RESPONSIBILITIES/TASKS:* Oversees all principal activities related to maintaining, developing, and executing on the MA financial arrangements including, but not limited to, carve out vendors, incremental arrangements, and ad hoc pricing.* Creates short and long term solutions that addresses key areas of concern for Key Accounts and serves as an executive sponsor representing MA on committees/workgroups to ensure successful implementation.* Works in tandem with other client teams to develop strategic plans and principal activities related to servicing external representatives* Oversees all principal activities related to MA Contracts established between the customer and BCBSM/BCN, to minimize any and all financial risks and to maintain current standards on agreed upon performance levels.* Oversees all principal activities related to servicing and escalated inquiries and appeals generated regarding the MA plan.* Oversees all principal activiti es related to MA data reporting and data analytics for Large Accounts.* Oversees all principal activities related to CMS initiatives for the segment both internally and externally, including, but not limited to, providing strategic direction, consulting, communications, and reporting.* Directs a team responsible for ensuring Key Accounts customer satisfaction for MA products.* Performs other related duties required.* Provides vision, leadership, planning, project coordination, and management for the development of a cost-effective department while concurrently facilitating efficient operations to meet current and future business needs within the organization.* Represents Company in community and industry, programs, and conferences.* Upon request, functions as the key account department head in the absence of the executive leader.* Participates in the development of programs as a strategic partner that supports the company plan.* Participates in development of annual departmental budget, monitors budget, and identifies budget discrepancies. Researches cause and make recommendations.* Responsible for balancing workload to optimize the effectiveness of the department.* Perform as the key interface between the client and internal business units in support of BCBSM key Medicare Advantage accounts.* Prepares account presentations and ongoing reporting to assigned BCBSM Medicare Advantage Accounts utilizing Strategic, Clinical, and Marketing data from various sources throughout the enterprise.* Acquiring a thorough understanding of key customer needs and requirements. Identify current and future account demands to add value and help senior health customers.* Expanding the relationships with existing customers by continuously proposing solutions that meet their objectives.* Develop trusting relationships with assigned key clients to ensure t hey do not turn to competition.* Effectively communicate activities, both verbally and via monthly written reports, with the assigned key account teams, product development, and services on a timely basis.* Participate in the definition of a global, joint action plan for the accounts.