We need an Account Manager with hands-on experience owning health plan relationships and a working command of payer operations. This role owns the commercial relationship for a named book of health plan accounts in the assigned metro, drives retention and expansion against the plan’s own operating problems, and acts as the commercial counterpart to delivery across everything Simplify Alpha runs under the SolaaS model. Three things are non-negotiable and are screened before anything else: payer domain fluency, a track record selling technology and technology enabled services into health plans, and a working understanding of AI.
Key Responsibilities:
• Own a named book of accounts in the assigned metro and coverage radius, accountable for retention, expansion, and relationship health
• Build and maintain a live stakeholder map per account covering economic buyer, operational sponsor, technical evaluator, procurement, and detractors, with multi-threaded coverage treated as a requirement rather than a goal
• Run a business review cadence with each account, quarterly at minimum for strategic accounts, and maintain predictable in person presence within market accounts
• Identify whitespace against real payer operating pain (benefit configuration backlog, provider data accuracy, claims rework, enrollment reconciliation, appeals and grievances turnaround, Stars and quality gaps) and map it to Simplify Alpha offerings under the ALPHA framework
• Build the business case with the client using their own cost, cycle time, rework, and accuracy baselines rather than generic benchmarks
• Partner with solution and delivery leadership to scope new work, and stay accountable through statement of work execution
• Act as the commercial counterpart to the delivery lead on every engagement: know the actual delivery status, surface risk before the client does, and own the client side of escalations
• Protect scope and margin, routing pricing, discounting, and contract term exceptions through the delegation of authority rather than answering in the room
• Maintain an account plan per strategic account, refreshed quarterly
• Feed structured market intelligence back to product, solution, and commercial leadership: competitive displacement attempts, pricing pressure, budget cycle timing, regulatory drivers, and reorganizations inside the plan
The first three are absolute. A candidate missing any one of them is a no regardless of the rest of the profile.
• Payer domain understanding: demonstrable depth in United States health plan operations across at least two of: benefit plan configuration, provider data and network management, claims processing and adjudication, enrollment and membership, appeals and grievances, quality and Stars, risk adjustment. Understands the differences in operating model across commercial, Medicare Advantage, Medicaid, and exchange lines of business
• Payer technology sales: a track record selling technology or technology enabled services into health plans specifically. Knows the payer buying centers (CIO, COO, Chief Digital or Transformation Officer), how payer budget and procurement cycles run, and what security review, third party risk assessment, and vendor onboarding actually require. Provider side, life sciences, or general enterprise technology sales do not substitute
• AI understanding: a working, current grasp of how AI is applied in payer operations, including automation of document and configuration heavy workflows, agentic and rules-based approaches, and where accuracy, auditability, human in the loop review, and data protection constraints set the real boundary. Must be able to hold a substantive conversation with a plan technology leader and to distinguish a credible capability claim from an oversold one, including our own
• Seven or more years in account management, client partnership, or enterprise sales, with at least four of those selling to or working inside United States health plans
• Track record owning a book of business with quantified retention and expansion outcomes, verifiable in reference
• Experience selling or managing services, managed services, or platform plus services engagements rather than perpetual license software alone
• Ability to operate with delivery and engineering teams as peers, including distributed and offshore teams across time zones
• Disciplined CRM and forecasting practice, able to articulate their own methodology for calling commit versus best case
• Written clarity sufficient that a follow up note can be forwarded by a client sponsor to their CFO unedited
• Resident in the base metro or committed to relocating before start date