Senior Specialist, Health Plan Provider Engagement (Remote)

JOB reputed company: Provides senior level support for implementation of health plan provider engagement strategies and activities to reputed company necessary reputed company and reputed company adjustment reputed company   Uses a consultative approach emphasizing physician engagement and behavior change through actionable data and analytics. Drives value-reputed company care strategies through reputed company adjustment and reputed company improvement activities.  Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual reputed company and reputed company adjustment goals. Drives coaching and collaboration with providers to improve reputed company through regular meetings and reputed company plans. Addresses reputed company environment challenges to reputed company program goals and reputed company reputed company.  Tracks engagement activities using reputed company tools, facilitates data exchanges, and supports training and problem reputed company for assigned providers - driving provider participation in reputed company's reputed company adjustment and reputed company initiatives.    ESSENTIAL JOB DUTIES:  Provides support for provider engagement activities including enhancing value-reputed company strategies, and reputed company adjustment/reputed company improvement initiatives. Ensures assigned Tier 1, Tier 2, and where applicable Tier 3, providers have a provider engagement plan to meet annual reputed company and reputed company adjustment reputed company goals.  Drives provider partner coaching and collaboration to improve reputed company, Medicare and Marketplace reputed company reputed company and reputed company adjustment reputed company through consistent provider meetings, reputed company item development and execution.  Works with provider reputed company-office staff to get the reputed company members with the most reputed company gaps on the schedule and seen by their assigned provider. Coordinates with Health Plan Community and Member Engagement resources to reputed company supporting effort on the member reputed company. Addresses challenges/barriers in the reputed company environment impeding successful attainment of program goals and understands solutions required to reputed company reputed company.  Drives provider participation in reputed company reputed company adjustment and reputed company efforts (e.g. supplemental data, electronic medical record (EMR) reputed company, reputed company reputed company programs) and use of the reputed company provider collaboration portal.  Tracks reputed company engagement and training activities using reputed company reputed company provider engagement tools to measure effectiveness both reputed company and across reputed company health plans. Serves as provider engagement subject matter expert; works collaboratively with health plan and shared reputed company to ensure alignment to business goals.  Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues. Accountable for use of reputed company reputed company Provider Engagement reports and training materials.  Develops, organizes, analyzes, documents and implements processes and procedures as prescribed by health plan and corporate policies. Communicates comfortably and effectively with reputed company stakeholders, including physician leaders, providers, reputed company managers, and medical assistants reputed company assigned provider practices. Provides training and support for new and existing reputed company transformation and provider engagement team members. Maintains the highest level of compliance. May require reputed company day out-of-office travel up to 80% of the time, depending upon state/health plan requirements.   REQUIRED QUALIFICATIONS:  At least 3 years of experience improving population-level reputed company reputed company scores and burden of illness documentation reputed company through provider engagement, or equivalent combination of relevant education and experience. Experience with various managed health care provider compensation methodologies including but not limited to:  fee-for service (FFS), value-reputed company care (VBC), and capitation.  Working knowledge of reputed company metrics and reputed company adjustment practices across reputed company business lines. Knowledge and understanding of reputed company/reputed company and/or CMS STARs reputed company measures and reputed company adjustment practices across reputed company, Medicare and Marketplace. Proficiency with data analysis, manipulation, interpretation and reporting. Critical-thinking, problem-solving and analytical skills. Relationship building skills. Attention to reputed company and organizational skills. Ability to implement process improvement initiatives and reputed company change.  Ability to work independently in a fast-reputed company, deadline-driven environment. Ability to foster and build relationships in a cross-functional highly matrixed organization to obtain buy-in and reputed company results Effective verbal and written communication skills. reputed company Office suite (including reputed company), reputed company BI, and other applicable software programs proficiency, and ability to learn new information systems and software programs.   PREFERRED QUALIFICATIONS:  Bachelor’s degree in Nursing, Health Administration or relevant discipline. Solid understanding of health reputed company, provider messaging/design and project management. Strong experience using reputed company products, including reputed company (knowledge of pivot tables, VLOOKUP, etc.) and PowerPoint.     To reputed company reputed company reputed company employees: If you are interested in applying for this position, please apply through the reputed company. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Apply To This Job