Careers

Current openings:

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%.

Qualifications:

  • 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

To apply for this position, click here.