Sr. Medicare Network Manager (Remote)

Jobgether; California (MO); Remote; USD 65,000 - 85,000; Full time

Benefits offered by this job

Health and Life Insurance Plans

401(k) with company matching

Flexible Scheduling options

Paid Time Off and Holiday Pay

Leadership Mentoring Opportunities

Job summary

A healthcare services provider is seeking a Senior Medicare Network Manager to oversee the development of specialized networks tailored for Medicare Advantage populations. This remote role involves managing vendor relationships, ensuring operational excellence, and providing critical support to transportation providers. Ideal candidates have 2-5 years of experience in account management and possess excellent negotiation and communication skills. Join a dynamic team and contribute to providing quality services to Medicare patients.

Qualifications

• High School diploma or GED required.
• 2-5 years’ experience as an Account Manager is essential.
• Valid driver’s license is necessary.

Responsibilities

• Manage daily interactions with vendors like an Account Manager.
• Work with Transportation Providers to resolve service issues.
• Ensure high operational standards and vendor satisfaction.

Skills

Account Management

Operational Experience

Negotiation Skills

Communication Skills

Time Management

Attention to Detail

Customer Empathy

Education

High School Diploma or GED

College Degree or Equivalent Work Experience

Tools

Salesforce

Job description

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Senior Medicare Network Manager - REMOTE. In this role, you will play a vital part in developing and maintaining specialized networks tailored to the needs of Medicare Advantage populations. You will ensure high operational standards and vendor satisfaction, managing daily interactions with vendors like an Account Manager. Your ability to build strong relationships across functional departments will be critical to maintaining efficient and effective networks, ultimately contributing to the overall success of our partners in providing quality services.

Accountabilities

• Work with Transportation Providers to resolve service issues and troubleshoot problems.
• Utilize data to develop and implement performance improvement plans (PIP).
• Coordinate and conduct monthly provider performance evaluations.
• Handle offboarding for providers not meeting expected standards.
• Serve as the primary contact for vendor service requests and escalations.
• Manage day-to-day vendor interactions and ensure satisfaction.
• Conduct on-site vehicle inspections and audits for compliance with standards.
• Deliver operational support to all vendors in a designated geographic area.
• Collaborate with internal teams to resolve Transportation Provider issues.
• Provide consultations and guidance to Transportation Providers and internal staff.
• Utilize Salesforce for managing vendor interactions and compliance.
• Educate Transportation Provider contacts on operational processes.
• Foster partnerships with assigned transportation providers.
• Assist in facilitating regular provider town hall meetings.
• Address inbound service requests and ensure proper assignment.
• Liaise with internal departments to resolve vendor inquiries.
• Support transportation providers with claims, payments, and eligibility questions.
• Meet assigned KPIs and business objectives.
• Ensure compliance through inspections and audits.
• Submit provider configuration changes to the data management team.

Requirements

• High School diploma or GED required.
• College Degree or Equivalent Work Experience preferred.
• 2-5 years’ experience as an Account Manager is essential.
• Minimum of 2 years’ operational experience required.
• Valid driver’s license is necessary.
• Ability to conduct inspections and audits courteously.
• Demonstrate excellent time management skills.
• Knowledge of transportation logistics and managed care is a plus.
• Ability to maintain a positive attitude in high-stress situations.
• Strong negotiation and communication skills.
• Attention to detail is critical.
• Ability to maintain confidentiality at all times.
• Skilled in prioritizing projects and incidents.
• Empathize with customer needs and circumstances.
• Ability to handle emergent situations appropriately.

Benefits

• Health and Life Insurance Plans.
• Dental and Vision Plans.
• 401(k) with company matching.
• Flexible Scheduling options.
• Paid Time Off and Holiday Pay.
• Maternity/Paternity Leave.
• Birthday Holiday benefits.
• Casual Dress Environment.
• Tuition Reimbursement programs.
• Perks Discount Program.
• Leadership Mentoring Opportunities.

Why Apply Through Jobgether?

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role\'s core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.