Provider Network Account Executive I

AmeriHealth Caritas; United States; Remote; USD 55,000 - 85,000; Full time

Job summary

AmeriHealth Caritas seeks a Community Health Choices Provider Network Account Executive I to foster partnerships with healthcare providers and ensure quality care delivery. This remote position requires expertise in managed care and relationship management, interfacing with a diverse range of healthcare stakeholders to coordinate effective support and education.

Benefits

Remote work options

Flexible work schedules

Competitive pay

Paid time off including holidays

Health insurance from Day 1

401(k) plan

Tuition reimbursement

Qualifications

• 1 to 3 years in a Provider Services position with providers.
• 3 to 5 years in the managed care/health insurance industry.
• Preferred experience with Medicare, Medicaid, or ACA Exchange.

Responsibilities

• Serve as primary liaison between the Plan and assigned providers.
• Conduct tailored provider onboarding and resolve issues.
• Monitor network adequacy and ensure compliance with standards.
• Analyze provider performance and implement improvement strategies.
• Prepare and submit timely reports on activities and metrics.

Skills

Trust-building partnerships

Issue management

Initiative

Time management

Collaborative teamwork

Education

Bachelor's degree or equivalent experience

High school diploma/GED

Job description

Your career starts now. We're looking for the next generation of healthcare leaders.

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 healthcare 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, PA, 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: At AmeriHealth Caritas, we believe that strong provider relationships are the foundation of quality care. As a Community Health Choices (CHC) Provider Network Account Executive I, you’ll play a vital role in building and nurturing those connections. In this position, you’ll be a trusted partner to a diverse portfolio of healthcare providers—including solo practitioners, multi-site groups, and integrated delivery systems—ensuring they have the support and resources needed to deliver exceptional care to our members.

Work Arrangement:

• Remote - Associate can work remotely anywhere in the United States.

Responsibilities:

• Serve as the primary liaison between the Plan and assigned providers, ensuring a deep understanding of contract terms, provider needs, and performance expectations.
• Conduct tailored provider onboarding and educational sessions, and issue resolutions to support provider engagement and satisfaction.
• Monitor network adequacy and ensure compliance with state and federal access standards across all product lines.
• Identify and recruit qualified providers in new and existing service areas, ensuring alignment with financial and contractual requirements.
• Analyze provider performance using Plan reports and metrics; develop and implement improvement strategies based on data insights.
• Support corrective action processes, including provider terminations, by Plan policies.
• Collaborate with the Quality Management team on credentialing, re-credentialing, member complaints, and quality of care investigations.
• Maintain accurate provider data in Facets and coordinate updates with the Provider Maintenance Department.
• Prepare and submit timely reports on activities, metrics, and outcomes.
• Build and sustain effective partnerships with internal departments and stakeholders.

Education & Experience:

• A bachelor's degree or equivalent experience is required.
• A high school diploma/GED is required.
• 1 to 3 years of experience in a Provider Services position working with providers.
• 3 to 5 years of experience in the managed care/health insurance industry.
• Medicare, Medicaid, or ACA Exchange experience preferred.

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.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. We keep our associates happy so they can focus on keeping our members healthy.

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.