Provider Programs Specialist PH Risk Adjustment

spectrumhealth; Grand Rapids (MI); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Comprehensive benefits package

On-demand pay program by Payactiv

Discounts directory for deals

Identity theft protection

Traditional and Roth retirement with 2

Flexible scheduling options

Job summary

Corewell Health is seeking a Provider Program Specialist in Grand Rapids to collaborate across the Risk Adjustment department, planning and implementing programs within our provider network. You will develop communications plans and disseminate tactics to drive performance on strategic initiatives.

The role involves coordinating multiple projects, supporting program evaluation, and delivering messaging to internal and external audiences, including webinars and trainings.

Qualifications

• Bachelor's Degree or equivalent is required.
• 2 years of relevant experience related work.
• CRT-Certified Professional Coder (CPC) - American Academy of Professional Coders Risk Adjustment Only 180 Days required Or
• CRT-Coding Specialist (CCS) - AHIMA Risk Adjustment Only 180 Days

Responsibilities

• Partner with internal teams and serve as a liaison to providers, community partners, and network stakeholders to support strategic initiatives, programs, training, and engagement activities.
• Coordinate and manage multiple projects simultaneously, including project scope, timelines, milestones, resource requirements, deliverables, and performance tracking.
• Support the assessment, planning, implementation, and evaluation of programs and interventions designed to improve network efficiency, health outcomes, and patient experience.
• Coordinate the implementation and monitoring of clinical pilot programs to ensure achievement of program goals, objectives, and deadlines.
• Analyze, review, and communicate network performance information related to RA initiatives
• Develop strategic communications, messaging, and educational materials for internal and external audiences, including provider network partners.
• Support provider-facing engagement activities, including webinars, meetings, trainings, presentations, and other educational events.
• Develop written reports, presentations, and communication materials to support program initiatives and operational goals.
• Collaborate with stakeholders at all levels of the organization to plan, implement, and evaluate provider network programs and initiatives.
• Develop strategic communications, messaging, and tactics to the provider network for Risk Adjustment initiatives and Coding Documentation Improvement (CDI) efforts.

Education

Bachelor's Degree or equivalent

CRT-Certified Professional Coder (CPC) - AAPC

CRT-Coding Specialist (CCS) - AHIMA

Job description

Job Summary

The provider program specialist is a role in the Risk Adjustment department that collaborates with teams across the organization to plan, organize, and implement programs within our provider network. A key function of this role is the development of strategic communications plans and messaging and the creation and dissemination of communication tactics to internal and external audiences to drive provider performance on our strategic initiatives.

Essential Functions

• Partner with internal teams and serve as a liaison to providers, community partners, and network stakeholders to support strategic initiatives, programs, training, and engagement activities.
• Coordinate and manage multiple projects simultaneously, including project scope, timelines, milestones, resource requirements, deliverables, and performance tracking.
• Support the assessment, planning, implementation, and evaluation of programs and interventions designed to improve network efficiency, health outcomes, and patient experience.
• Coordinate the implementation and monitoring of clinical pilot programs to ensure achievement of program goals, objectives, and deadlines.
• Analyze, review, and communicate network performance information related to RA initiatives
• Develop strategic communications, messaging, and educational materials for internal and external audiences, including provider network partners.
• Support provider-facing engagement activities, including webinars, meetings, trainings, presentations, and other educational events.
• Develop written reports, presentations, and communication materials to support program initiatives and operational goals.
• Collaborate with stakeholders at all levels of the organization to plan, implement, and evaluate provider network programs and initiatives.
• Develop strategic communications, messaging, and tactics to the provider network for Risk Adjustment initiatives and Coding Documentation Improvement (CDI) efforts.

Qualifications

Required

• Bachelor's Degree or equivalent
• 2 years of relevant experience related work
• CRT-Certified Professional Coder (CPC) - American Academy of Professional Coders American Academy of Professional Coders Risk Adjustment Only 180 Days required Or
• CRT-Coding Specialist (CCS) - AHIMA American Health Information Management Association Risk Adjustment Only 180 Days

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here .
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance
• Traditional and Roth retirement options with service contribution and match savings
• Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Priority Health - 1241 E BeltlineAve NE - Grand Rapids

Department Name

Risk Adjustment Executive - PH Managed Benefits

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

8 a.m. to 5 p.m.

Days Worked

Monday to Friday

Weekend Frequency

N/A

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity