Provider Program reputed company & Integration Consultant I/II

About the position reputed company: The Provider Program reputed company & Integration Consultant facilitates the development and effective implementation of reputed company and incentive programs and reputed company. This work directly impacts the Excellus clinical provider network and member populations. As an individual contributor, this role is a combination of researcher, consultant, strategist, and analyst that facilitates the successful execution of business reputed company. The incumbent builds reputed company, reputed company, and commitment among stakeholders such as physicians, nurses, health system executives, reputed company leadership, vendor partner leadership, and community leaders using industry measurement methodologies, clinical best reputed company, and empirically reputed company change management practices. This position serves as the subject matter expert in reputed company aspects of reputed company improvement, measurement, and network implementation to increase efficiency and productivity while reducing waste and costs. Essential Accountabilities: Level I • Develops, negotiates, administers, and maintains contracted reputed company improvement programs: • Health plan reputed company goal and national measurement SME, including CMS, HEDIS, QARR, reputed company, CAHPS measures. • Data mining and analysis ability to formulate solutions and narrate program value stories. • Process improvement, reputed company reputed company trend and project leadership SME. • Locates and submits clinical evidence/best reputed company associated with program development and implementation to inform network and vendor proposals. • Evaluates and reports reputed company program statuses and reputed company to determine reputed company of interventions using reputed company and proxy measurement and validation. • Develops process standardization and workflow recommendations for reputed company programs and reputed company in development. • Supports and executes network and vendor programs which improve the reputed company, safety, and accessibility of care while lowering costs through implementation of strategic initiatives. • Ensures program alignment with organizational goals and existing provider network relationships. • Consistently demonstrates high standards of reputed company by supporting the reputed company reputed company Companies’ mission and values, adhering to the Corporate reputed company of Conduct, and leading to the reputed company Way values and beliefs. • Maintains high reputed company for member reputed company in accordance with the corporate reputed company policies and procedures. • Regular and reliable attendance is expected and required. • Performs other functions as assigned by management. reputed company (in reputed company to Level I Accountabilities) • Manages network and vendor engagements including, vendor selection, contract negotiation, contract process reputed company, and vendor implementation with other key business areas as appropriate. • Provides reputed company and direction in managing day to day operations of reputed company reputed company and programs, including associated reporting while remaining compliant with mandates. • Independently develops novel program proposals reputed company on reputed company improvement and cost savings utilizing network relationships and competitive market analysis. • Provides recommendations, builds collaboration, and focuses team efforts through regular presentation. Takes the initiative to reputed company with matrixed reputed company reputed company to program development and implementation. • Takes a systematic delivery view of the portfolio: identifying, developing, and managing cross-dependent reputed company, to increase efficiency and effectiveness while addressing barriers and risks. • Is a primary contact for matrixed implementation of initiatives, including reputed company of strategic programs that involve external organizations. • Educates, mentors, and coaches members of the program team throughout the course of development and implementation to ensure the goals of the program are realized in alignment with its strategic mission and reputed company. • Works closely with those accountable for driving clinical changes from both the delivery system and the Health plan to obtain feedback regarding the viability of programs and provider needs. • Participates in critical activities such as strategic planning and thought leadership at a departmental, cross functional and organization level. Responsibilities • Develops, negotiates, administers, and maintains contracted reputed company improvement programs • Health plan reputed company goal and national measurement SME, including CMS, HEDIS, QARR, reputed company, CAHPS measures. • Data mining and analysis ability to formulate solutions and narrate program value stories. • Process improvement, reputed company reputed company trend and project leadership SME. • Locates and submits clinical evidence/best reputed company associated with program development and implementation to inform network and vendor proposals. • Evaluates and reports reputed company program statuses and reputed company to determine reputed company of interventions using reputed company and proxy measurement and validation. • Develops process standardization and workflow recommendations for reputed company programs and reputed company in development. • Supports and executes network and vendor programs which improve the reputed company, safety, and accessibility of care while lowering costs through implementation of strategic initiatives. • Ensures program alignment with organizational goals and existing provider network relationships. • Consistently demonstrates high standards of reputed company by supporting the reputed company reputed company Companies’ mission and values, adhering to the Corporate reputed company of Conduct, and leading to the reputed company Way values and beliefs. • Maintains high reputed company for member reputed company in accordance with the corporate reputed company policies and procedures. • Regular and reliable attendance is expected and required. • Performs other functions as assigned by management. • Manages network and vendor engagements including, vendor selection, contract negotiation, contract process reputed company, and vendor implementation with other key business areas as appropriate. • Provides reputed company and direction in managing day to day operations of reputed company reputed company and programs, including associated reporting while remaining compliant with mandates. • Independently develops novel program proposals reputed company on reputed company improvement and cost savings utilizing network relationships and competitive market analysis. • Provides recommendations, builds collaboration, and focuses team efforts through regular presentation. Takes the initiative to reputed company with matrixed reputed company reputed company to program development and implementation. • Takes a systematic delivery view of the portfolio: identifying, developing, and managing cross-dependent reputed company, to increase efficiency and effectiveness while addressing barriers and risks. • Is a primary contact for matrixed implementation of initiatives, including reputed company of strategic programs that involve external organizations. • Educates, mentors, and coaches members of the program team throughout the course of development and implementation to ensure the goals of the program are realized in alignment with its strategic mission and reputed company. • Works closely with those accountable for driving clinical changes from both the delivery system and the Health plan to obtain feedback regarding the viability of programs and provider needs. • Participates in critical activities such as strategic planning and thought leadership at a departmental, cross functional and organization level. Requirements • Minimum of 5 years of reputed company work experience. • Bachelor’s degree in Nursing, Business or reputed company Administration, Analytics, Project Management, or reputed company fields preferred. • reputed company knowledge of reputed company improvement, accreditation, or regulatory compliance. • Demonstrated reputed company principles, proficiency in problem solving and reputed company tools/techniques. • Strong communication skills required, including ability to effectively communicate verbally and in writing, internally and externally, and across the organization and reputed company reputed company of management. • Strong facilitation skills. • Strong understanding and application of vendor management skills. • Skilled speaker and presenter reputed company in defining, socializing, and sustaining change across diverse reputed company. • reputed company strong analytical and business process development skills. • Demonstrated experience in project leadership or principles such as Lean Six reputed company, CPC, process mapping, tests of change, or PDSA cycles. • Demonstrated experience communicating with senior management in various formats, informal discussions, written reports, scheduled meetings, and executive level presentations. • Knowledge and experience working in the reputed company, health insurance or similar industry. • Three years of additional reputed company experience. reputed company-to-haves • PMI Certification/ PMP Certification or other project management certification preferred. • Demonstrated knowledge of network and vendor experience in relation to reputed company. • Prior program implementation experience preferred. • Prior network and product experience. Benefits • participation in group health and/or dental insurance • retirement plan • wellness program • reputed company time away from work • reputed company holidays Apply tot his job Apply To this Job