[Hiring] Provider Engagement Specialist @Alignment Health

Role Description

The field remote Provider Engagement Specialist is responsible for developing and maintaining strong relationships with provider offices to improve network performance, enhance provider satisfaction, and support organizational growth. This field remote role partners with providers in person on strategies to increase patient retention and growth, while also driving performance across key quality and utilization metrics. The Provider Engagement Specialist serves as the main point of contact for providers, offering education, support, and tools to achieve goals.

General Duties/Responsibilities

• Build and maintain collaborative relationships with providers and their staff to support growth, retention, and performance improvement.
• Partner with providers to improve performance on key performance indicators (KPIs), including but not limited to growth, retention, Annual Wellness Visits (AWVs), HEDIS gap closures, hospital and ER utilization, risk adjustment and other quality indicators.
• Conduct initial provider onboarding and provide support for ongoing provider education on Alignment tools, clinical programs, PCP incentives, Member benefit offerings, Model of Care and other compliance requirements, and Alignment initiatives.
• Assist in the development of training and educational materials/tools. Create provider in-service and implementation packets.
• Facilitate and serve as a single point of resolution for provider issues, including but not limited to UM, prior authorization, claims, encounter data, eligibility, provider rosters and directory validation.
• Represent Alignment Health at provider meetings, trainings, and community events. Document meeting minutes and action items as needed.
• Consistently utilize, update and maintain department databases and tracking tools to ensure provider engagement activities, provider visits and outcomes are documented and monitored.
• Negotiate and implement standard physician and ancillary agreements; obtain provider credentialing; utilize network database to track recruitment activity.
• Maintain weekly summary of activity and submit reports on a weekly basis.
• Attend and participate in all staff meetings as required.
• Perform special projects as assigned.

Minimum Requirements

• Two years related experience and/or training; or equivalent combination of education and experience.
• Experience in provider relations / contracting with an HMO or IPA, medical group or institutional provider required.
• B.A./B.S. or equivalent combination of education and experience.
• Bi-lingual English/Spanish – preferred.
• Organized, detail driven and a self-starter.
• Strong analytic, quantitative, and problem-solving skills.
• Strong verbal and written communication skills.
• Relationship-builder and team-player.
• Strong presentation skills and ability to address diverse audiences appropriately and effectively.
• Proficient user in MS office suite (Word, Excel and PowerPoint).
• 80% or more travel by car routinely required (In assigned market). Travel by plane required as needed.
• Maintenance of reliable means of transportation and valid driver’s license and automobile insurance required.
• Extended work hours, as needed. Remote work on approval.

Essential Physical Functions

• Regularly required to sit; use hands to finger, handle, or feel and talk or hear.
• Frequently required to reach with hands and arms.
• Occasionally required to stand; walk; climb or balance and stoop, kneel, crouch, or crawl.
• Must occasionally lift and/or move up to 25 pounds.
• Specific vision abilities required include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Pay Range

$54,434.00 - $81,651.00. Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Equal Opportunity Statement

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

Disclaimer

Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/ . If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected] .