Sr. Specialist, Quality Provider Engagement - RN / LPN Preferred - Remote

Overview

The Sr Specialist, Provider Engagement role implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities.

In Short

• Implements provider engagement strategies to meet quality and risk adjustment goals.
• Coaches and collaborates with providers to improve performance.
• Addresses practice environment challenges to achieve program goals.
• Tracks engagement activities and supports the Provider Engagement team.
• Communicates effectively with healthcare professionals.
• Maintains compliance with policies.
• Facilitates data exchanges and training for providers.
• Develops and implements processes as per corporate policies.
• Requires same-day out-of-office travel up to 80% of the time.

Requirements

• Bachelor’s degree in Business, Healthcare, Nursing, or related field.
• Minimum 3 years of experience in provider quality performance improvement.
• Experience with managed healthcare provider compensation methodologies.
• Strong knowledge of quality metrics and risk adjustment practices.
• Demonstrates data analytic skills.
• Operational knowledge of PowerPoint, Excel, and Visio.
• Effective communication and strong leadership skills.

Benefits

• Competitive benefits and compensation package.
• Equal Opportunity Employer (EOE).