Provider Engagement Specialist

Blue Cross of Idaho; Coeur d'Alene (ID); Remote; USD 64,000 - 91,000; Full time

Job summary

A leading healthcare provider seeks a Provider Engagement Specialist to promote and strengthen provider relationships through education and outreach. This full-time position requires a Bachelor's degree, relevant industry experience, and certifications. The candidate will manage performance metrics and develop training materials, primarily servicing Northern Idaho.

Benefits

Paid time off

Paid holidays

Medical/dental/vision insurance

401(k) matching

Education reimbursement

Qualifications

• 2+ years’ experience in provider service, coding, or health industry.
• Bachelor’s Degree or equivalent experience required.
• Must hold relevant coding certifications.

Responsibilities

• Promotes provider relationships and enhances continuous education.
• Analyzes risk adjustment performance reports.
• Conducts training for provider practices.

Skills

Provider service

Risk adjustment analysis

Education

Bachelor’s Degree

Tools

Certified Professional Coder Certification (CPC)

Clinical Certification/Clinical License

Job description

Provider Engagement Specialist page is loaded

Provider Engagement Specialist

Apply locations Idaho - Coeur d'Alene - Home Office Remote - Home Office time type Full time posted on Posted 5 Days Ago job requisition id R3104

The Provider Engagement Specialist promotes, contributes, and grows provider relationships by providing education, engagement, and/or outreach activities. Promotes and enhances relationships with providers to invest in the health of members. Responsible for the overall performance of assigned practices within risk adjustment programs.

This role is located in Northern Idaho and will be servicing the provider offices in that region.

Required Experience:2/+ years’ provider service, coding, or health industry experience

Required Education: Bachelor’s Degree or equivalent work experience (Two years’ relevant work experience is equivalent to one-year college)

Required Licenses/Certifications:

• Must hold: Certified Professional Coder Certification (CPC) or Clinical Certification/Clinical License (MA or above)
• Certified Risk Coder Certification, or must obtain within one year of date of hire

Travel:Typically 2-3 days a week twice a month to clinic offices in Northern Idaho. Travel to Blue Cross of Idaho's main campus in Meridian, Idaho (once per quarter).

Your day may look like:

• Develops content and conducts training to assigned practices. Influences, develops, and maintains provider education materials related to risk adjustment.
• Manages and coordinates the creation, distribution and collection of clinical documentation and coding improvement tools.
• Analyzes and interprets provider risk adjustment performance reports. Develops and implements plans to meet target performance metrics.
• Interprets and maintains current risk adjustment regulatory rules and guidelines to ensure compliance standards are maintained within internal policies, procedures, and workflows.
• Analyzes reporting or provider education programs to identify opportunities for education and/or enhanced reporting.
• Identifies and leads performance improvement projects that maximize provider value-based reimbursements.
• Performs risk adjustment medical record reviews as a primary coder and communicates findings to providers.

As of the date of this posting, a good faith estimate of the current pay range is $64,893 to $90,850. The position is eligible for an annual incentive bonus (variable depending on company and employee performance.

The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, internal equity, geography, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer.

We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program.

We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.

Reasonable accommodations

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

About Us

Blue Cross of Idaho has taken our role as an Idaho-based health insurance company to heart since 1945.As a not-for-profit, we are driven to help connect Idahoans to quality and affordable healthcare while building strong networks and services.

We aim to create a brighter future for all with the help of customer-centric professionals.

Your Health and Wellness Matters
At Blue Cross of Idaho, we care about the health and well-being of our employees.Ourbenefits aim to help make your life easier, healthier and morebalanced.

We believe in employee growth, which is why we offer training, tools and numerous resources to assist with professional development.

Your CommunityMatters
Our employees care deeply about Idaho.We work together to positively impact communities throughout Idaho, and contribute our time through volunteering.

Blue Cross of Idaho will extend reasonable accommodations to qualified individuals with disabilities who are otherwise not able to fully use electronic and online job application systems. For assistance, please send an email to [e-mail] .