Remote Provider Engagement & Growth Specialist

Alignment Health; United States; Hybrid; USD 54,000 - 82,000; Full time

Benefits offered by this job

Remote work on approval

Job summary

Alignment Health seeks a Provider Engagement Specialist to build and sustain relationships with provider offices, improving network performance and growth while driving quality and utilization outcomes.

You will partner with providers on onboarding, education, and tools to achieve goals, including AWVs, HEDIS gaps, and incentive programs. Travel is required in the assigned market, with remote work approved as needed.

Qualifications

• Two 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.
• BA/BS or 2 years relevant experience

Responsibilities

• 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 growth, retention, 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 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.

Skills

Analytical skills

Quantitative skills

Problem solving

Verbal written communication

Relationship builder

Education

BA/BS or equivalent experience

Tools

MS Office

Job description

Alignment Health seeks a Provider Engagement Specialist to build and sustain relationships with provider offices, improving network performance and growth while driving quality and utilization outcomes.

You will partner with providers on onboarding, education, and tools to achieve goals, including AWVs, HEDIS gaps, and incentive programs. Travel is required in the assigned market, with remote work approved as needed.