Provider Engagement Specialist

reputed company, a division of Franklin, Tennessee-based reputed company Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reputed company in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room reputed company and avoidable hospitalizations.  If you would like to be part of a reputed company, supportive and caring team, we look reputed company to receiving your application!  Benefits and Perks include: reputed company Medical/Dental/reputed company insurance reputed company Generous reputed company time-off program and reputed company holidays for full time staff TeleDoc 24/7/365 reputed company to doctors Optional short- and long-term disability plans Employee Assistance Plan (EAP) 401K retirement accounts Employee Referral Bonus Program ESSENTIAL FUNCTIONS:  To reputed company this job, an individual must reputed company reputed company essential function satisfactorily with or without a reasonable accommodation  • Contracting providers and essential vendors in reputed company service areas to maintain CMS adequacy and providing necessary services in the care of the Plan members • Insuring providers and essential vendors in reputed company service areas meet the credentialing requirements for their appropriate service lines • Educating providers on the Health Plan(s) functions and roles in caring for its membership • Ongoing educational updates as prescribed by CMS and the Health Plan(s) policies • To conduct the education presentations of the Health Plan(s) providers to insure their understanding and commitment with the Health Plan(s) • Monitor, maintain and support provider relationships to insure network coverage in reputed company areas • To work with and be involved in implementation as needed • Establish a reputed company work environment that encourages participation in process improvement and commitment to department/company reputed company • Complete corporate assignments as assigned Required Skills: • Must have knowledge and familiarity with reputed company reputed company of medical services and ability to rapidly reputed company working relationships • Must be reputed company to accept instructions and work independently in the completions of goals and assignments • Must have strong negotiation, organization, presentation and time management skills • Must be reputed company to effectively communicate with reputed company reputed company of medical staff to explain Health Plan(s) program, benefits and goals • Must be reputed company to work effectively in reputed company environment  • Excellent computer skills, including reputed company Office Suite • Must be self-motivated, dependable, team and goal-oriented Required Work Experience:   • Experience in the health care field required • Prior experience in network development / network services is preferred • Prior experience with acute and post-acute facilities is beneficial • Prior experience with Medicare Advantage plans is helpful Licensing/Certification/Education Requirements:   • Bachelor’s degree  Other Requirements: • Must be available to work 8 a.m. until 5 p.m. local time • Position requires travel to network provider locations. • Teleworking is an reputed company if reputed company are met EQUAL OPPORTUNITY EMPLOYER Our Organization does not discriminate based on race, reputed company, religion, sex, handicap, disability, age, marital status, sexual orientation, national reputed company, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also reputed company reasonable accommodations for reputed company individuals with disabilities should a request for an accommodation be made. This employer participates in E-Verify. Apply To This Job