- Manage assigned account activities and ensure efficient execution of client deliverables and service expectations
- Analyze reporting data to validate alignment with client intent and plan setup
- Identify trends and discrepancies
- Resolve client and member-level issues by coordinating with internal teams
- Develop tailored solutions that meet client needs and maintain CMS compliance for Medicare accounts
- Monitor account performance
- Contribute to centralized support initiatives that enhance operational efficiency
- Communicate with clients and internal departments to ensure transparency and alignment
- Lead multifaceted issues through investigation, stakeholder engagement, root cause analysis, and implementation of sustainable solutions
Requirements
- 3+ years of experience in account management, customer service, healthcare administration, or relevant business environment
- Experience managing complex issues, escalations, or cross-functional initiatives with demonstrated ownership and accountability for outcomes
- Advanced analytical and problem-solving skills
- Strong critical thinking and decision-making capabilities
- Excellent verbal and written communication skills
- Ability to prioritize competing demands while maintaining quality and meeting deadlines
- Strong organizational and project coordination skills with attention to detail and follow-through
- Ability to identify improvement opportunities and contribute to operational excellence initiatives
- Knowledge of healthcare, health insurance, pharmacy benefit management, Medicare, Medicaid, or other government-sponsored healthcare programs
- Understanding of CMS regulations, compliance requirements, and healthcare operational processes
- Experience with case management, issue management, CRM, or workflow management systems such as Salesforce
- HS Diploma/GED and 3+ years of relevant work experience
- Associate degree or relevant work experience
Core Competencies
Demonstrates expertise in account management and client service within the healthcare sector, with a strong focus on compliance with CMS regulations and operational excellence. Proficient in analytical problem-solving, communication, and project coordination to enhance client deliverables and service expectations.
Highest-signal resume keywords
- Account Management
- Healthcare Compliance
- Analytical Problem-Solving
- Client Communication
- Project Coordination
ATS Optimization Keywords
Hard Skills
- Data Analysis
- Trend Identification
- Root Cause Analysis
- Issue Management
- Operational Efficiency
Soft Skills
- Critical Thinking
- Decision-Making
- Organizational Skills
- Attention to Detail
- Verbal Communication
Industry Keywords
- Healthcare Administration
- Medicare
- Medicaid
- Pharmacy Benefit Management
- CMS Regulations
Tools & Technologies
- CRM Systems
- Salesforce
- Workflow Management Systems