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Alignment Health

Provider Engagement Specialist – Field Remote (Tulare / Kern / Kings, CA)

RemoteUnited States only
Published
Experience
Mid
Employment
Full-time
$58.5k–$87.8k/yr
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Open to US only. Set where you work from to check your eligibility.

No BS summary

Field-remote Provider Engagement Specialist needed to build relationships with physician practices in Tulare/Kern/Kings, CA. Requires 2+ years of experience in provider relations/contracting with an HMO/IPA/medical group. Must be comfortable with travel (80%), self-directed scheduling, and reporting. Bilingual English/Spanish preferred.

Required skills

MS Office suiteWordExcelPowerPoint

Optional skills

Bilingual English / Spanish

Required languages

English

Optional languages

Spanish

What you'll do

  • 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.

What they require

  • Minimum Experience: (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
  • 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.
  • 80% or more travel by car routinely required (In assigned market).
  • Travel by plane required as needed.
  • Maintenance of reliable means of transportation and valid driver’s license and automobile insurance required.
  • Extended works hours, as needed.
  • Remote work on approval.
  • (2) years related experience and/or training; or equivalent combination of education and experience.

Benefits

  • Mileage and travel expenses reimbursed in accordance with company policy

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail.

HealthcareEnterprise

What people say about this company

2.9/ 5

  • Mixed reviews on management effectiveness.
  • Some employees appreciate the mission and values of the company.
  • Concerns about work-life balance and workload.
Also posted in 1 other channel
$58.5k–$87.8k/yr