Managed Care Account Manager

Foundation Risk Partners; Orange (CA); On-site; USD 95,000 - 115,000; Full time

Job summary

Foundation Risk Partners is seeking a client service professional focused on managed care and reinsurance. The role requires collaboration with Producers and clients, ensuring high-quality service in policy management and documentation.

The ideal candidate has 4+ years of experience, strong Excel skills, and a client-first approach. The position offers a pay range of $95,000 - $115,000 USD depending on qualifications.

Qualifications

• Minimum of 4 years experience in managed care, reinsurance, or provider stop-loss.
• Knowledge of EPIC or similar agency management system preferred.
• Accident & Health insurance license is suitable or Property & Casualty License.

Responsibilities

• Provides daily administrative and client service support.
• Gathers and prepares renewal data including claims experience.
• Processes policy changes, renewals, and documentation.
• Ensures accurate and timely execution of transactions.
• Maintains client communication and invoices accounts.

Skills

Analysis of managed care and reinsurance

Independent work

Organizational skills

Microsoft Excel proficiency

Communication skills

Attention to detail

Collaboration skills

Client-first approach

Education

4 years of experience in managed care or reinsurance

Accident & Health insurance license or Property & Casualty License

Tools

EPIC or similar agency management system

Job description

Collaborates with the team to consistently deliver high-quality service to managed care clients with a focus on reinsurance and provider stop-loss programs. Ensures service standards including execution, delivery, and retention are achieved. Provides efficient, professional, and courteous service to clients by phone, in writing, and in person.

Thee role is responsible and accountable for risk by openly exchanging ideas and opinions, elevating concerns, and personally following policies and procedures as defined. Accountable for always doing the right thing for customers and colleagues and ensures that actions and behaviors drive a positive customer experience.

Essential Functions

• Provides daily administrative and client service support to Producers, Account Executives, and managed care clients within reinsurance and provider stop-loss programs.
• Gathers, reviews, and prepares renewal data including claims experience, large claimant reports, premium and rate history, and exposure information.
• Supports a Middle Market book consisting of managed care, provider stop-loss, and reinsurance programs; experience in these areas is highly preferred.
• Processes policy changes, renewals, and documentation including binders, confirmations of coverage, and program summaries.
• Assists clients with claims reporting and coordinates with carriers, TPAs, and internal teams throughout the lifecycle of claims.
• Ensures that all assigned transactions are executed accurately and in a timely manner with documentation maintained to standards.
• Maintains client communication to ensure understanding of program structure, coverage, and obligations.
• Invoices accounts and assists with tracking receivables and premium payments where required.
• Prepares renewal strategy materials and identifies opportunities for program enhancements.
• Works renewal timelines to support retention and client satisfaction.
• Maintains accurate client data within agency systems in accordance with procedures.

Competencies & Qualifications

• Ability to analyze complex managed care, reinsurance, and stop-loss arrangements and communicate clearly. Familiarity with provider contracting. An understanding of CMS alternative capitated payment model. Understanding of capitated payment models.
• Ability to work independently with limited supervision.
• Strong organizational skills with the ability to manage multiple priorities.
• Advanced proficiency in Microsoft Excel is required, strong working knowledge of Word and PowerPoint.
• Strong verbal and written communication skills.
• High attention to detail and accuracy.
• Ability to collaborate effectively with clients, carriers, TPAs, and internal teams.
• Demonstrates a client-first approach.

Education & Experience

• Minimum of 4 years of related experience in managed care, reinsurance, or provider stop-loss.
• Knowledge of EPIC or similar agency management system preferred.
• Accident & Health insurance license is suitable or Property & Casualty License.

Salary

Pay Transparency Range: $95,000 - $115,000 USD

Equal Employment Opportunity

FRP provides equal employment opportunity to qualified persons regardless of race, color, sex, religion, national origin, age, sexual orientation, gender identity, disability, veteran status, or any other classifications protected by law.