Provider Engagement Specialist – Field

🕒 May 26

🤠 Texas – Remote

🤠 Texas – Remote

💵 $54.4k - $81.7k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

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Alignment Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

👥 B2C

💰 $321.1M Post-IPO Debt - Alignment Health on 2024-11

Healthcare Insurance • B2C

Alignment Health is a Medicare-focused health insurance company that offers Medicare Advantage plans and member-centered services. It provides 24/7 on-demand access to care via in-person, in-home, and mobile channels and features a concierge-style on-demand card to help members schedule appointments, arrange transportation, and answer health questions. Alignment Health partners with brokers, providers, Accountable Care Organizations (ACOs), and institutional partners, operates in multiple U. S. states (including Arizona, California, Nevada, North Carolina, and Texas), and has earned high CMS ratings and industry recognition.

📋 Description

• Build and maintain collaborative relationships with providers and their staff to support growth, retention, and performance improvement. • Partner with providers to improve performance on key performance indicators (KPIs), including but not limited to growth, retention, Annual Wellness Visits (AWVs), HEDIS gap closures, hospital and ER utilization, risk adjustment and other quality indicators. • Conduct initial provider onboarding and provide support for ongoing provider education on Alignment tools, clinical programs, PCP incentives, Member benefit offerings, Model of Care and other compliance requirements, and Alignment initiatives. • Assist in the development of training and educational materials/tools. • Create provider in-service and implementation packets. • Facilitate and serve as a single point of resolution for provider issues, including but not limited to UM, prior authorization, claims, encounter data, eligibility, provider rosters and directory validation. • Represent Alignment Health at provider meetings, trainings, and community events. • Document meeting minutes and action items as needed. • Consistently utilize, update and maintain department databases and tracking tools to ensure provider engagement activities, provider visits and outcomes are documented and monitored. • Negotiate and implement standard physician and ancillary agreements; obtain provider credentialing; utilize network database to track recruitment activity. • Maintain weekly summary of activity and submit reports on a weekly basis. • Attend and participate in all staff meetings as required. • Perform special projects as assigned.

🎯 Requirements

• (2) years related experience and/or training; or equivalent combination of education and experience • Experience in provider relations / contracting with an HMO or IPA, medical group or institutional provider required • B.A./B.S. or equivalent combination of education and experience • Bilingual English / Spanish (preferred) • Organized, detail oriented, and a self-starter. • Strong analytic, quantitative, and problem-solving skills. • Strong verbal and written communication skills. • Relationship-builder and team-player • Strong presentation skills and ability to address diverse audiences appropriately and effectively. • Proficient user in MS office suite (Word, Excel and PowerPoint).

🏖️ Benefits

• Mileage and travel expenses reimbursed in accordance with company policy