Provider Engagement Specialist

🔥 30 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $58.5k - $87.8k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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Alignment Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

🛡️ Insurance

🏥 Healthcare

💰 $135M Series C on 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health is dedicated to providing comprehensive care for Medicare members, emphasizing the needs of seniors, the chronically ill, and those who are frail. With a mission to transform senior healthcare, Alignment Health leverages a tailored care model and advanced technology to deliver high-quality, low-cost healthcare services. Their 24/7 concierge care team collaborates with trusted local providers to ensure that every member receives personalized care, reflecting the company's commitment to treating all members as valued family members.

📋 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

🎯 Requirements

• 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

🏖️ Benefits

• 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