Medicare Provider Growth & Engagement Specialist

Alignment Health; North Carolina; Presencial; USD 54.000 - 82.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Remote work on approval

Descripción de la vacante

Alignment Health is seeking a Provider Engagement Specialist in North Carolina to build and sustain strong relationships with provider offices, driving growth and improving key quality metrics. You will educate and support providers on Alignment programs, coordinate onboarding, and act as the primary point of contact for escalations while traveling to provider sites as needed.

In this role, you will partner with providers to improve performance on KPIs such as AWVs, HEDIS gap closures, and

Formación

• Two years related experience and/or training; or equivalent combination of education and experience.
• Education/Licensure: B.A./B.S. OR 2 years relevant experience.
• Bi-lingual preferred.
• 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.
• Proficient in MS Office (Word, Excel, PowerPoint). 80%+ travel by car routinely required; plane travel as needed; valid driver’s license and automobile insurance required.

Responsabilidades

• Build and maintain collaborative relationships with providers to support growth, retention, and performance improvement.
• Partner with providers to improve performance on key indicators (KPIs) including growth, retention, AWVs, HEDIS gap closures, hospital and ER utilization, risk adjustment, and other quality metrics.
• Conduct initial provider onboarding and provide ongoing provider education on Alignment tools, clinical programs, PCP incentives, member benefits, Model of Care and other compliance requirements.
• Assist in developing training and educational materials/tools; create provider in-service and implementation packets.
• Facilitate and serve as a single point of resolution for provider issues (UM, prior authorization, claims, encounter data, eligibility, provider rosters, directory validation).
• Represent Alignment Health at provider meetings, trainings, and community events; document meeting minutes and action items.
• Maintain department databases and tracking tools; document provider engagement activities, visits, and outcomes.
• Negotiate and implement standard physician and ancillary agreements; obtain provider credentialing; track recruitment activity.
• Maintain weekly summary of activity and submit reports on a weekly basis.
• Attend and participate in staff meetings; perform special projects as assigned.
• Remote work on approval.

Conocimientos

Analytical skills

Verbal and written communication

Relationship building

Presentation skills

Team player

Bi-lingual preferred

Educación

B.A./B.S. OR 2 years relevant experience

Herramientas

MS Office: Word, Excel, PowerPoint

Descripción del empleo

Alignment Health is seeking a Provider Engagement Specialist in North Carolina to build and sustain strong relationships with provider offices, driving growth and improving key quality metrics. You will educate and support providers on Alignment programs, coordinate onboarding, and act as the primary point of contact for escalations while traveling to provider sites as needed.

In this role, you will partner with providers to improve performance on KPIs such as AWVs, HEDIS gap closures, and