Coordinator, Provider Engagement
Locations: Charlotte, Raleigh, Wilmington
Position Purpose: Reporting to the Senior Director, Provider Engagement -- Performance and Analytics, the Coordinator, Provider Engagement will perform initial health plan orientation and conduct ongoing educational outreach with a focus on improving quality and financial outcomes within the provider network
- Conduct initial provider orientations as well as ongoing educational outreach for assigned providers
- Assist providers in achieving pay-for-performance milestones
- Generate and interpret reports for providers based on detailed HEDIS and/or HBR (Health Benefits Ratio) analysis and review provider performance by both quantitative metrics and qualitative factors
- Create and communicate milestone documents, dashboards and success metrics
- Provide status updates for providers regarding incentive agreements
- Conduct site visits to improve quality and financial outcomes
- Act as a liaison between the provider and the health plan ensuring a coordinated effort in improving financial and quality performance
- Engage providers to solicit and build on their ideas/interests related to quality performance measurement
- Collaborate with Care Management, Quality and others across the Health Plan and Network
- Educate providers regarding policies and procedures related to referrals, claims submission, web site education, Electronic Health Records, Health Information Exchange, and Electronic Data Interface
- Engage providers on Advanced Medical Home / Patient Centered Medical Home initiatives
- Support Contracting duties as requested
- Travel (local and overnight): up to 50%.
- Bachelor’s degree in related field preferred; or equivalent experience
- 3+ years of project management, provider relations, health care operations, or medical management
- Experience in Managed Healthcare or Medicaid/Medicare industry preferred.
- Excellent written, oral, and presentation skills required.
- Ability to work collaboratively with staff and contractors at all levels.
- Well developed organizational skills and attention to detail
- High proficiency with Microsoft Office products as well as communication productivity tools.
- Current state driver’s license
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