Provider Engagement Specialist - Field Based

Alignment Healthcare USA, LLC in; Merced (CA); Híbrido; USD 59.000 - 88.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Mileage reimbursement

Flexible schedule

Field-based role

Descripción de la vacante

Alignment Health is seeking a proactive, field-based Provider Engagement Specialist to support and strengthen our provider network in Merced and Stanislaus Counties. This role emphasizes relationship-building with physician practices and provider groups, aiming to optimize performance and patient outcomes.

You will onboard providers, educate on programs and resources, and collaborate with teams to drive quality initiatives, while maintaining documentation, reporting, and coordination with

Formación

• Bachelor's degree (B.A./B.S.) preferred; or an 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 is required.

Responsabilidades

• Build and maintain strong, collaborative relationships with healthcare providers and office staff.
• Partner with providers to improve performance across growth, retention, AWVs, HEDIS gap closure, hospital and emergency room utilization, risk adjustment, and other quality measures.
• Lead provider onboarding and deliver ongoing education on Alignment Health programs, tools, incentives, member benefits, Model of Care requirements, compliance standards, and organizational initiatives.
• Develop and deliver provider training materials, educational resources, implementation guides, and presentations.
• Serve as the primary point of contact for provider needs and operational support, including utilization management, prior authorizations, claims, eligibility, encounter data, provider rosters, and directory validation.
• Represent Alignment Health at provider meetings, training sessions, networking events, and community engagements.
• Support network expansion efforts through physician and ancillary provider contracting, recruitment, and credentialing activities.
• Maintain accurate provider engagement documentation, activity reports, tracking databases, and meeting records.
• Participate in team meetings and contribute to special projects and strategic initiatives.

Conocimientos

Relationship-building

Verbal communication

Written communication

Analytical mindset

Organizational skills

Self-starter

Educación

Bachelor's degree

Herramientas

MS Word

Excel

PowerPoint

Descripción del empleo

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. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. At Alignment Health, we're committed to transforming the healthcare experience for seniors through strong provider partnerships and innovative care solutions. We're seeking a proactive, relationship-driven, and highly organized Provider Engagement Specialist to support and strengthen our growing provider network throughout Merced and Stanislaus Counties. In this highly visible, field-based role, you'll serve as a trusted partner to physician practices and provider groups, helping them optimize performance, improve patient outcomes, and successfully navigate Alignment Health's programs and resources. You'll play a key role in advancing quality initiatives, supporting network growth, enhancing provider satisfaction, and strengthening long-term partnerships across the market. This opportunity is ideal for a self-motivated professional who enjoys building relationships, solving complex challenges, driving measurable results, and making a meaningful impact on healthcare delivery.

Why Join Alignment Health?

• Field-based role with approximately 80% travel throughout Merced/Stanislaus County
• Flexible, self-managed schedule with autonomy in your day-to-day work
• Opportunity to work directly with physicians, practice leaders, and healthcare organizations
• Meaningful role influencing provider success and member health outcomes
• Occasional travel (1-2 times annually) for meetings, training, and conferences
• Mileage and travel expenses reimbursed according to company policy
• Primarily Monday-Friday during provider office hours, with flexibility for occasional early morning, evening, or community events

Essential Duties & Responsibilities

• Build and maintain strong, collaborative relationships with healthcare providers and office staff.
• Partner with providers to improve performance across growth, retention, Annual Wellness Visits (AWVs), HEDIS gap closure, hospital and emergency room utilization, risk adjustment, and other quality measures.
• Lead provider onboarding and deliver ongoing education on Alignment Health programs, tools, incentives, member benefits, Model of Care requirements, compliance standards, and organizational initiatives.
• Develop and deliver provider training materials, educational resources, implementation guides, and presentations.
• Serve as the primary point of contact for provider needs and operational support, including utilization management, prior authorizations, claims, eligibility, encounter data, provider rosters, and directory validation.
• Represent Alignment Health at provider meetings, training sessions, networking events, and community engagements.
• Support network expansion efforts through physician and ancillary provider contracting, recruitment, and credentialing activities.
• Maintain accurate provider engagement documentation, activity reports, tracking databases, and meeting records.
• Participate in team meetings and contribute to special projects and strategic initiatives as assigned.

Requirements

• 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.
• Education Bachelor's degree (B.A. or B.S.) preferred; or an equivalent combination of education and experience.

Preferred Qualifications

• Bilingual English/Spanish preferred.
• Experience working directly with physician practices and healthcare providers.
• Knowledge of Medicare Advantage, quality improvement programs, risk adjustment, utilization management, and provider performance metrics.
• Knowledge, Skills & Abilities Exceptional relationship-building and interpersonal skills.
• Strong verbal and written communication abilities.
• Effective presentation, facilitation, and provider education skills.
• Analytical mindset with strong quantitative and problem-solving abilities.
• Highly organized, detail-oriented, and able to manage multiple priorities.
• Self-starter with the ability to work independently while collaborating across teams.
• Ability to engage and influence diverse provider audiences.
• Proficiency with Microsoft Office Suite, including Word, Excel, and PowerPoint.

Travel Requirements

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. Extended or flexible work hours may occasionally be required.

Essential Physical Functions

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is frequently required to reach with hands and arms. The employee is occasionally required to stand; walk; climb or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Pay Range

Pay Range: $58,531.00 - $87,797.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

Alignment Health is championing a new path in senior care that empowers members to age well and live their most vibrant lives. Our mission-focused team makes high-quality, low-cost care a reality for members every day. Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most. We believe that great work comes from people who are inspired to be their best. We've built a team of people who want to make a difference in the lives of the seniors we serve. Come join the team that is changing health care — one person at a time.