Provider Engagement Account Executive (Queens/Bronx, NY - Hybrid)

Company Description

CRD Careers is a boutique recruitment agency specializing in Sales and HR placements.
We connect growth-minded companies with high-impact professionals who drive real results. Whether you're building a team or building a career, our approach is precise, people-first, and built for long-term success.

We don’t do buzzwords—we do outcomes.

Job Description

Position Purpose: As a Provider Engagement Account Executive, you will own the strategic partnerships between the health plan and our contracted provider networks in the Queens and Bronx markets. You will serve as the primary C-suite liaison, driving performance improvement, value-based care initiatives, and operational excellence.

Key Responsibilities:

• Strategic Relationship Management: Cultivate deep relationships with hospital systems and large multi-specialty groups. Act as the primary point of contact for C-suite executives and provider leadership.

• Performance Improvement: Drive provider performance in critical metrics including HEDIS/Quality, Health Benefit Ratio (HBR), risk adjustment, and cost utilization.

• Value-Based Care: Lead initiatives to align providers with value-based performance (VBP) agreements. Use data analytics to track performance and offer actionable feedback to optimize patient care and cost-efficiency.

• Operational Solutions: Investigate and resolve complex, high-volume, or high-dollar claim issues. Educate providers on policies, referrals, claims submission, and EDI tools to prevent recurring issues.

• Reporting & Analytics: Present detailed HBR analysis and create comprehensive reports for Joint Operating Committee (JOC) meetings.

• Leadership: Act as a lead for external representatives, providing coaching, training, and mentorship to the broader team.

• Field Presence: This is a hybrid role requiring local travel (up to 4 days/week) to conduct in-person visits with physicians and administrators for real-time support and strategy alignment.

Qualifications

Education & Experience:

• Bachelor’s degree in a related field (or equivalent experience) is required.

• Master’s Degree in Public Health (MPH), Health Administration (MHA), or Business Administration (MBA) is highly preferred.

• 5+ years of experience in managed care, medical group operations, provider relations, quality improvement, or utilization management.

Key Skills & Competencies:

• Deep Knowledge of Quality Metrics: Highly proficient in HEDIS measures, risk adjustment, cost containment, and utilization management.

• Project Management: Proven ability to manage complex projects within a medical group, IPA, or health plan setting.

• Executive Presence: Ability to influence desired outcomes at the executive level and synthesize complex issues for multi-disciplinary teams.

• Technical Proficiency: Strong understanding of value-based performance tools and data analytics.

Additional Information

Why This Role Matches Your Career:

• Impact: You are not just managing accounts; you are transforming healthcare delivery for underserved populations in New York.

• Growth: Join a Fortune 500 industry leader with clear paths for advancement.

• Compensation: Competitive base salary ($115,000 – $120,000) with a comprehensive benefits package.

Benefits:

• Competitive Pay & Performance Incentives

• Medical, Dental, and Vision Insurance

• 401(K) with company match

• Stock Purchase Plans

• Tuition Reimbursement

• Paid Time Off + Holidays

Next Steps: Click "Apply Now" to submit your resume. Our Talent Team will review your application immediately.