Director of Health Plan Sales and Network Management

Job Overview

Description

• Lead the Sales team, establish priorities, identify gaps and create solutions.
• Develop and implement strategies to increase sales of health plan products.
• Prospect and engage new clients, offering customized solutions based on their needs.
• Achieve and exceed sales targets by identifying opportunities for growth in key markets.

• Lead the Network team, establish priorities, review current workflows and advance where appropriate, identify gaps and create plans to close.
• Build, maintain, and manage relationships with healthcare providers, ensuring the delivery of high-quality care at the lowest net cost.  
• Negotiate contracts with hospitals, physicians, and specialists strategically to strengthen provider networks as appropriate to meet company objectives.
• Ensure compliance with industry regulations and maintain high standards of care within the network.

• Provide ongoing support to clients and policyholders to ensure their satisfaction with services.
• Educate clients about available health insurance plans and their benefits.
• Resolve complex issues related to claims, billing, and coverage with empathy and professionalism.

• Analyze market trends, competitor activities, and regulatory changes to identify new opportunities and challenges.
• Report regularly to senior management on sales performance, provider network health, and customer feedback.

• Proven experience in health insurance sales, provider relations, or a related field.
• Strong negotiation, communication, and interpersonal skills.
• In-depth knowledge of the healthcare industry, insurance products, and regulations.
• Ability to build and nurture long-term relationships with providers, clients, and stakeholders.
• A proactive and results-driven approach to achieving business objectives.

• Competitive compensation package including base and commissions with generous benefit program and relocation
• Single or Family Health Insurance with discounted premium rates for wellness program participation.
• 401k with immediate matching (50% on the dollar up to 7% of pay + additional annual Profit Sharing
• Flexible Paid Time Off Program
• Medical and Dependent Care Flex Spending Accounts
• Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc. 

1. Strategic Planning and Goal Setting: Proactively manage projects and long-term goals, establish timelines and action owners, ensure commitments are met.
2. Decision Making and Resource Management: Gather information, evaluate impacts and risks, make timely decisions, manage resources responsibly.
3. Leadership and Team Building: Set an example, model respectful and cooperative relationships, ensure team understanding and collaboration, motivate employees, address morale issues.
4. Communication and Relationship Building: Communicate openly and effectively, build commitment and loyalty, manage difficult issues with empathy and clarity, promote a non-threatening environment for expressing opinions. Interact professionally, build rapport, treat everyone with respect.
5. Innovation and Change Management: Implement new ideas and technologies, support change, remove obstacles, ensure resources are available.
6. Performance Management and Development: Set performance and behavioral standards, promote personal accountability, encourage skill development and goal attainment, provide feedback and evaluations, support employee development and succession planning.  Remain current with skills and industry knowledge and seek feedback for continual personal development.
7. Customer Focus and Commitment to Excellence: Anticipate internal and external customer needs, respond proactively and ensure satisfaction. Demonstrate commitment to excellence, deliver quality work.
8. Policy Compliance and Ethical Behavior: Comply with Medical Associates policies and behave in an ethical manner at all times.

Physical Aspects:

Reaching - Extending hand(s) and arm(s) in any direction.

Lifting - Raising objects from a lower to a higher position or moving objects horizontally from position-to-position. This factor is important if it occurs to a considerable degree and requires the substantial use of the upper extremities and back muscles.

Fingering - Picking, pinching, typing or otherwise working, primarily with fingers rather than with the whole hand or arm as in handling.

Grasping - Applying pressure to an object with the fingers and palm.

Talking - Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately, loudly or quickly.

Hearing - Perceiving the nature of sound with or without correction. Ability to receive detailed information through oral communication and to make fine discriminations in sound, such as when making fine adjustments on machined parts.

Vision - 20 / 40 or better in the best eye with or without correction.

Repetitive Motions - Substantial movements (motions) of the wrists, hands and/or fingers.

Sedentary Work - Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

Medical Associates Clinic & Health Plans is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, age, national origin, marital status, parental status, disability, veteran status, or other distinguishing characteristics of diversity and inclusion, or any other protected status.

Please view Equal Employment Opportunity Posters provided by OFCCP https://www.eeoc.gov/poster