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Account Manager (RN or LPN)

Curana Health • Full-time • Detroit, MI, USA • 1m ago

Job Details

Job Location: Detroit, MI - Detroit, MI

Position Type: Full Time

Salary Range: Undisclosed

Description

Curana Health is a provider of value-based primary care services for the senior living industry, including skilled nursing facilities, assisted & independent living communities, Memory Care units, and affordable senior housing sites. Our 1,000+ clinicians serve more than 1,500 senior living community partners across 34 states, and Curana participates in various innovative CMS programs (including owned-and-operated Accountable Care Organizations and Medicare Advantage plans). With rapid year-over-year growth since our founding in 2021, Curana is setting a new standard in innovative care delivery for seniors with high-risk, complex clinical needs, many of whom have been historically underserved by the healthcare system. Our mission: To radically improve the health, happiness and dignity of senior living residents.

Responsibilities

Engages in supporting all Plan activities including Network Relationships, Plan Enrollment, Operations, member and provider support
Executes on strategies and goals set by the Plan Board of Directors, Plan Executive Director, and the Senior Management Team for improving operational execution and delivering value to customers and members.
Coordinates with the Sales team to establish member growth programs and manage campaigns to achieve top line revenue targets.
At the direction of the Executive Director, prepares Board meeting materials and packets, prepares and distributes regular Plan reports, and maintains regular weekly or bi-weekly meetings with Plan Partners.
Identifies operating business risks/opportunities and identifies strategies to mitigate/capitalize as appropriate.
Works directly with the Plan’s leadership team to provide prompt, friendly provider relations and customer service.
Meets regularly with key Plan physicians, physician staff, and SNF/NF facilities to gauge satisfaction with the Plan, communicate key Plan initiatives, and maintain a sense of Plan community.
Actively supports securing contracts with Providers for “preferred” and “required” network adequacy as needed.
With the Executive Director, manages network strategy, adequacy, and access and service.
Identifies new business opportunities in Plan markets.
Monitors and reports on key financial metrics for the Plan; is knowledgeable about Plan financial reporting.
Contributes to the Plan’s operating budget.
Works directly with the operating team to solve customer service and provider relations issues.
Assist vendors/facilities/etc with how to bill us
Assist vendors/facilities/etc with portal issues
Portal Training/System Issues
Annual benefit document review, marketing reviews for errors
Gathering stats and agenda items for partner meetings
Network support, tracking, and managing issues (credentialing, provider updates, rosters)
Miscellaneous disenrollment issues
Visiting partners to assist with engagement
Assist sales with Lunch and Learns
Meet with admins to review quality incentives, enrollment goals, overall education of the plan
Assist vendors/facilities/etc with ASC letters they receive, escalate if needed, help resolve the issue
Inbound calls from vendors/facilities/members/families for ad-hoc issues (including but not limited to OTC, how to look up a provider/medication/if a service is covered, etc)
Inbound emails from vendors/facilities/members/families for ad-hoc issues (including but not limited to OTC, how to look up a provider/medication/if a service is covered, etc)
Assist sales with broker education/ad-hoc needs
Assist with creating processes for current and future needs (CRM, disenrollment, how to order items, etc)
Assist plan management team with ad hoc requests
Coordinate meetings with current partners and plan management
Other Duties as assigned

Knowledge & Skills Required:

Bachelor's degree required
RN or LPN Required
Strong communication and presentation skills
At least 3 years of prior Medicare Advantage operations experience preferred
Familiarity with nursing facility financing
Technical and financial understanding of health care operations
Strong analytical and problem-solving skills
Excellent computer skills including Word and Excel

Curana Health is dedicated to the principles of Equal Employment Opportunity. We affirm, in policy and practice, our commitment to diversity. We do not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable or state law, genetic information, or any other characteristic protected by applicable federal, state and local laws and ordinances.

The EEO policy applies to all personnel matters as outlined in our company policy including recruitment, hiring, transfers, and general treatment during employment.

*The company is unable to provide sponsorship for a visa at this time (H1B or otherwise).

Qualifications

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