Account Executive I

About AmeriHealth Caritas

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Role Overview

We’re seeking a detail-oriented and relationship-driven Account Executive I to manage and support our network of contracted healthcare providers. In this role, you’ll build and maintain strong partnerships, conduct provider orientations, resolve issues, and ensure compliance with state and federal access requirements. You’ll monitor provider performance using data and metrics, support credentialing processes, and help drive improvements in service delivery.

Responsibilities

• Understand and manage the Plan’s contracts and provider performance, conduct tailored orientation sessions, educational visits, and resolve issues.
• Ensure appropriate access to services across the Plan’s territory in compliance with state and federal mandates.
• Identify, contact, and solicit qualified providers to join the Plan, ensuring financial integrity and adherence to contract requirements.
• Utilize plan reports and metrics to evaluate provider performance, communicate improvement plans, and foster stronger relationships.
• Assist in implementing corrective actions, including termination, as per the Plan policies.
• Aid in credentialing, re-credentialing, investigating member complaints, and addressing quality issues.
• Maintain knowledge of Facets and relay information about provider changes to the Provider Maintenance Department.
• Deliver accurate and timely activity and metric reports.
• Build strong partnerships with internal resources and stakeholders.

Education & Experience

• Bachelor’s degree or equivalent experience, high school diploma/GED required.
• 1 to 3 years in provider services
• 3 to 5 years in managed care/health insurance.
• Experience with Medicare, Medicaid, or Exchange, behavioral health, contract negotiations, value-based contracting, and provider auditing.

Work Arrangement

• Must live in CST or EST time zone
• Preferably candidates in or around PA.
• Possible travel to Annual Conferences

Skills & Abilities

• Establish and maintain trust-based partnerships with healthcare providers and internal teams.
• Manage and de-escalate provider concerns or issues with professionalism and diplomacy.
• Take initiative, manage time effectively, and complete tasks with minimal supervision.
• Balance competing demands across provider accounts, projects, and deadlines.
• Work effectively with cross-functional teams within internal departments.

Our Comprehensive Benefits Package

• Flexible work solutions including remote options, hybrid work schedules
• Competitive pay
• Paid time off including holidays and volunteer events
• Health insurance coverage for you and your dependents on Day 1
• 401(k)
• Tuition reimbursement and more.