DescriptionThe Associate Director, Provider Engagement develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Associate Director, Provider Engagement requires a solid understanding of how organization capabilities interrelate across department(s).
The Associate Director, Provider Engagement represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates.
- Bachelor's Degree
- 6+ years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
- 5+ years of demonstrated management experience and partnering with senior leadership on strategic initiatives
- 5+ years of demonstrated leadership and development experience
- Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
- Demonstrated ability to manage multiple projects and meet deadlines
- Comprehensive knowledge of all Microsoft Office applications
- Ability to travel as needed
- Masters Degree
- Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
- Comprehensive knowledge of Medicare policies, processes and procedures
This position requires up to 50% travel within IL and WI to meet with providers.
Scheduled Weekly Hours40