TO APPLY: EMAIL YOUR RESUME TO JOBS@MAESTROHEALTH.COM
We are… an employee health & benefits company with a tech-meets-service platform that simplifies and personalizes how employees and employers shop, enroll and live with their benefits. Our innovative technology makes it easy for employees to choose the right benefits plan while equipping HR with the tools they need through one partner, one service team, one platform, one portal.
Maestronites are… brought together with a passion to disrupt the status quo by reimagining employee health and benefits. This passion has driven us to create the first complete platform that optimizes the entire benefits experience for everyone. Our people, passion and platform are united by our mission: to make employee health & benefits people-friendly again.
WHAT YOU WILL BE DOING:
We are expanding our Health Plan Management Business. Our Health Plan Management business serves customers with 250-10,000 employees who self-fund their own group health plans. A cornerstone of our strategy is “Provider access and benefit costs”. This foundational role will lay the groundwork and help build our Network Management and Provider Relations team. Reporting to the President of the Health Plan Management business, you will help build and nurture relationships through traditional health plan networks and help to contract directly with providers. You will be responsible for evaluating the success of your team’s initiatives, processes and tools, regularly establishing goals for continuous improvement.You will coach and mentor team members through complex problems and be the point of accountability for strategic direction and escalated issues.
- Maintain a working in-depth knowledge and understanding of the Maestro Health products; where applicable and relevant, using additional resources where available and appropriate
- Work with Sales and Product leaders to identify new providers and networks that align with our customers’ needs
- Coordinate your team’s onboarding and logistics with new PPO network partners
- Lead direct contracting processes with professional and facility providers
- Ensure provider records are maintained accurately within CRM system that will feed downstream decision making and competitive intelligence
- Work with our General Counsel and legal team to navigate complex contractual processes and issues
- Create metrics and reporting that provide insights into coverage, disruption and performance of our relationships
- Work closely with service leadership to identify member and provider pain points and create solutions to address them
- Provide input for new process development and continuous improvement
- Act as the executive escalation point for provider relationship concerns
- Leads activities including maintenance of proper staffing levels, resource optimization, attainment of individual and team goals, employee relations, mentoring, talent/career development, and rewards/recognition based on achievement of goals
- Gain commitment, alignment and engagement in the pursuit of Maestro Health’s mission, vision and values.
- Recognize and monitor metrics identifying trends and opportunities.
- Ensure team members take full ownership in solving client problems and eliminating repetition of the same
- Provide regular status reports to stakeholders
- Develop project schedules, process flows and timelines, delegates tasks to meet deliverables, monitors and provides updates on the status of outstanding issues, process improvement and financials
- Be an effective and efficient partner for internal teams such as client, operations, service center, data management, production support and technology
WHAT SUCCESS LOOKS LIKE
- Maintain high level of access to care for new and existing customersIncreased performance and differentiation of our provider relationships
- Improved outcomes for members, employers and the providers in the communities we serve
- You are recognized as demonstrating our core values: Fun. Preparedness. Teamwork. Humility. Urgency. Bold Thought. Honesty.
WHAT DO YOU NEED
- BA/BS in Business Administration, Human Resources, or other related field; or equivalent in education and experience
- At least 5 years of experience in Network, Provider and Payer contracting; preferably a mix of experience with each audience
- Knowledge of contracting methodologies, roles, responsibilities and challenges
- Strong understanding of healthcare financing, access issues, delivery systems, quality controls, and related healthcare regulation
- Familiarity with in bundled service and alternative payment strategies
- Ability to effectively diagnose potential barriers and propose resolutions that have measurable and positive business impact
- Comfortable working in a fluid environment where there may be no clear solution
- Encourage and support accountability and engagement, including sharing of information, ownership and successes with others
- Exhibit Leadership Excellence, including identifying successful behaviors, ensuring the right talent in the right roles
- Prior success in building talent/leaders
- Ability to influence at all levels within an organization
- A relationship builder who partners collaboratively across all functional areas to ensure we are providing the best customer experience and are achieving our business objectives
- Viewed by others as a role model for ethical business behavior and personal integrity by internal team members and clients
- Ability to manage and prioritize your time based on whatever curve balls come your way and helping the team to resolve client issues efficiently
- Demonstrated ability to build relationships and understand clients’ needs
WHY WORK HERE:
We have great benefits:
- Personal, Vacation and Sick Time
- Medical and Prescription
- Life and Disability
- Health and Wellness programs
- 401k with Employee Match
- Figo – Pet Insurance
We have great perks in each of our offices, along with a fun, energetic and fast-paced environment, and what will really drive you is our vision. Maestro Health is making employee health & benefits people-friendly again by making healthcare easy to understand, tools easy to use, and costs easy to control. We are aiming to become a household name within the employee health & benefits space.
We can’t do that without great people. We want to hear “WOW! That was the best job and business experience I ever had!” from every Maestronite – past, present, and future. You should be personally challenged, laugh, work your tail off and look forward to coming to work.
Are you ready to become a Maestronite? Let’s do this.
Maestro Health is an equal opportunity workplace. We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or vetran status.