Provider Engagement Specialist

🕒 il y a 16 jours

🏄 California – Distant

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💵 $58 531 - $87 797 / an

⏰ Temps Plein

🟢 Junior

🟡 Intermédiaire

🚫👨‍🎓 Aucun diplôme requis

👻 Score fantôme 0%

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🗣️🇺🇸🇬🇧 Anglais requis

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Logo of Alignment Health

Alignment Health

501 - 1000 employés

Fondée en 2013

⚕️ Assurance santé

🛡️ Assurance

🏥 Santé

💰 €135 000 000 Series C en 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health se consacre à fournir des soins complets pour les membres de Medicare, en mettant l'accent sur les besoins des personnes âgées, des personnes atteintes de maladies chroniques et des personnes fragiles. Avec pour mission de transformer les soins de santé pour les seniors, Alignment Health utilise un modèle de soins personnalisé et une technologie avancée pour offrir des services de santé de haute qualité à faible coût. Leur équipe de soins de conciergerie disponible 24h/24 et 7j/7 collabore avec des prestataires locaux de confiance pour s'assurer que chaque membre reçoit des soins personnalisés, reflétant l'engagement de l'entreprise à traiter tous les membres comme des membres de la famille précieux.

Description

• Build and maintain collaborative relationships with providers and office staff • Partner with providers to improve growth, retention, AWVs, HEDIS gap closures, hospital and ER utilization, risk adjustment, and other quality metrics • Conduct provider onboarding and ongoing education on Alignment Health tools, programs, incentives, member benefits, Model of Care, compliance, and organizational initiatives • Develop provider training materials, implementation packets, and educational presentations • Serve as the primary point of contact for provider issues including UM, prior authorizations, claims, eligibility, encounter data, provider rosters, and directory validation • Represent Alignment Health at provider meetings, trainings, and community events • Negotiate and implement physician and ancillary agreements • Support provider credentialing and recruitment efforts • Maintain provider engagement documentation, tracking databases, activity reports, and meeting records • Attend staff meetings and perform special projects as assigned

🎯 Exigences

• Bachelor's degree (B.A. or B.S.) preferred, or equivalent combination of education and experience • Minimum of two (2) years of related experience and/or training • Experience in provider relations, provider contracting, network development, healthcare operations, managed care, IPA, HMO, medical group, or institutional provider environments required • Experience working directly with physician practices and healthcare providers • Knowledge of Medicare Advantage, quality programs, risk adjustment, utilization management, and provider performance metrics • Strong relationship-building and interpersonal skills • Excellent verbal and written communication abilities • Strong presentation and facilitation skills • Strong analytical, quantitative, and problem-solving capabilities • Highly organized, detail-oriented, and self-motivated • Ability to work independently and collaboratively • Ability to effectively engage diverse provider audiences • Proficiency with Microsoft Office Suite (Word, Excel, and PowerPoint) • Routinely required to travel by car throughout the assigned market (80% or more) • Must maintain reliable transportation, a valid driver's license, and automobile insurance • Air travel required as needed • Extended or flexible work hours may occasionally be required • Bilingual English/Spanish preferred

🏖️ Avantages

• Flexible, self-managed schedule • Initial training may include shadowing an established market team in Raleigh, NC • Occasional travel (1-2 times annually) for meetings, training, or conferences • Mileage and travel expenses reimbursed per company policy • Meaningful impact on seniors and communities served • Growth and innovation opportunities • Reasonable accommodations for individuals with disabilities • Equal Opportunity/Affirmative Action employment

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🗣️🇺🇸🇬🇧 Anglais requis