DescriptionThe Senior Provider Engagement Professional 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 Senior Provider Engagement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Provider Engagement Professional 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. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
- • Registered Nurse with no restrictions in state required to practice
• Proven successful experience in completing efficient health-related research, with associated analysis and conclusions
• Excellent PC skills (including MS Word, Excel and Outlook) required.
• Excellent communication skills, written and verbal
• Strong organizational skills
• Demonstrated ability to manage multiple projects and meet deadlines
• Includes Travel in Dothan, AL area
• Excellent skills working with a team
- • Knowledge of HEDIS and Quality Improvement Experience
• Bachelors degree
• Comprehensive knowledge of Medicare policies, processes and procedures
• Managed Care Experience a plus
Scheduled Weekly Hours40