[Hiring] Provider Outreach and Education Representative I @Noridian Healthcare Solutions, LLC

Role Description

The Provider Outreach and Education (POE) Representative is responsible for delivering Federal and State-aligned, data-driven education to providers and suppliers to reduce error rates, repeat provider inquiries, and claim submission errors. The role develops compliant education materials, analyzes operational data to identify risk and error trends, and coordinates education activities across internal and external stakeholders to improve provider understanding and reduce operational burden.

• Educates and facilitates provider education through webinars, teleconferences, in-person meetings, and workgroups as a subject matter expert aligned with Federal and State priorities.
• Possesses strong communication and organizational skills to successfully deliver education to executive level stakeholders.
• Builds relationships with subject matter experts within various divisions of Federal and State.
• Follows established quality standards for education documentation and assists with corrections or updates as needed.
• Analyzes data and tracks trends in claims errors, error rate findings, medical review referrals, and provider inquiries to develop targeted education.
• Assists in monitoring post education trends to evaluate the impact of education on provider inquiries, claims errors, and error rate findings.
• Maintains current and extensive knowledge of Federal and State rules, regulations, processing guidelines, and Internet-Only Manuals (IOM).
• Creates and maintains Federal and State-compliant, Section 508 accessible education materials and web content.
• Coordinates with internal departments to support operational improvement and reduce repeat work through education.
• Serves as a professional subject matter expert in Federal and State-mandated meetings and provider forums.
• Participates in aligning education activities to Federal and State identified risk areas.
• Documents education activities accurately and timely in Federal and State-required systems.
• Supports Federal and State-mandated POE activities including Advisory Groups, ACTs, and reporting requirements.
• Identifies process improvement opportunities and communicates recommendations to management.
• Ensures confidentiality, security, ISO, and Federal and State compliance requirements are met.

Qualifications

• Associate’s degree in Healthcare Administration, Health Information Management, Public Health, Business, Communications, Education, or related field; or equivalent combination of education and experience.
• 2 years Medicare experience.
• Strong analytical and communication skills.
• Experience applying Medicare policy, regulations or processing guidelines.

Requirements

• 4 years' Medicare experience (preferred).
• Provider education or public speaking experience (preferred).

Benefits

• Health, Dental and Vision Insurance.
• Voluntary Insurance Plans.
• Health Savings and Flexible Spending Accounts.
• 401k and Company Match.
• Company-paid Life Insurance.
• Education Assistance Program.
• Paid Sick Leave.
• Paid Holidays.
• Increasing PTO Accrual Plan.
• Medical/Parental/Disability Leave.
• Workers Compensation.
• Retiree Benefits.
• Severance Package.
• Employee Assistance Program.
• Financial and Health Wellness Benefits.
• Casual Dress.
• Open Office Setting.
• Online Learning System.